ABSTRACT
A total of 100 children with GHD of both sexes were included in this study. They were 29 females [29%] and 71 males [71%], and age ranged from 6.5-14 years. They were below 3 SDS for age and sex, growth velocity [cm/year] below the tenth centile for age and sex, growth hormone level below 10ng/ml [by two provocative tests]. Another 100 of normal children of both sexes, 25 females [25%] and 75 males [75%] and age ranged from 7-15 years as a control group. Both groups were subjected to the following: Full history taking and clinical examination, full anthropometric assessment that include the following: Target height, midparental height, height and growth velocity in cm/year. Skeletal maturity and bone age determination. Thyroid profile [free T3, T4. TSH], CBC, renal and liver function tests, karyotyping and cranial CT or MRI was done to exclude other causes of short stature. GH secretion by two provocative tests [clonidine and insulin tolerance tests] at one-week interval. IGF-I and IGFBP-3 were determined at diagnosis and after GH therapy for one year. Height SDS improved from -3.69 to-3.12 after GH therapy. The correlation between GH basal or peak and IGF-l or IGFBP-3 were not significant. We found also that IGF-l was highly specific for GH specially in the age groups [6-8 Y], [8-10Y] and [12-14 Y] and were 100%, 100% and 94.6% respectively, but on the other hand it was less sensitive in all age group except age group [10-12 Y] it was 75%. As regard IGFBP-3 it was highly specific in age group [12-14 Y] and [6-8 Y], 97.3% and 91.7% respectively and moderate to less specific in other age group, but it was less sensitive in all age group. we concluded that GH dose and schedule of GH injections used in the study for GHD patients is associated with a catch up growth followed by a period of steady growth. Both IGF-I and IGFBP-3 have high specificity in most age groups and this means that they can rule in GHD, but they can not rule out GHD because of low sensitivity. Combined screening for GHD using both IGF-l and IGFBP-3 may add some diagnostic information in comparison with the use of either test alone