ABSTRACT
Introduction: Despite the use of growth hormone replacement therapy for decades, our ability to make a definitive diagnosis of growth hormone deficiency in children is limited. Growth hormone stimulation tests have been used to discriminate between Growth hormone deficiency and idiopathic short stature. However all these tests lack reproducibility, accuracy, cost affectivity and safety. Insulin like growth factor-1 is an effector hormone and its serum level may be used as simple, easy to perform diagnostic test for growth hormone deficiency
Objective: To determine the efficacy of IGF-1 as a diagnostic tool in children with growth hormone deficiency
Study Design: Prospective cross sectional survey
Place of Study: Departments of Pediatrics and Pathology, Shalamar Medical and Dental College, Lahore
Duration of study: 1st July to 31st December, 2011
Material and Methods: We included 40 children of 3.5 - 17 year age and detailed clinical data was collected. All these children were subjected to stimulation by standardized exercise on treadmill, after taking basal blood samples for GH and IGF-1. Post stimulation growth hormone was recorded to identify growth hormone deficient children
Results: 17 [42.5%] children had post stimulation growth hormone level <10ng/ml while 23 [57.5%] had values >10ng/ml. Post exercise stimulation GH level showed weak correlation with IGF-1 in either of the two study groups. P value was found >0.05 in deficient as well as sufficient groups, depicting non significance of IGF-1 in relation to post stimulation GH level
Conclusions: IGF-1 is not a suitable surrogate diagnostic marker for growth hormone deficiency. Diagnosis should always be based on combination of auxological biochemical, radiological and genetic considerations