The usefulness of serum insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) for evaluation of children with short stature.

The diagnostic value of serum insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) was studied in 24 growth hormone deficient (GHD) and 36 normal variant short stature (NVSS) children. The serum IGF-1 and IGFBP-3 concentrations were markedly below the 5th centile for chronological age in all 24 GHD children, but were in the low normal range for age in most of the NVSS children. The concentrations of IGF-1 and IGFBP-3 significantly correlated with peak GH concentration, height age, and bone age. To account for the age- and sex-dependency, IGF-1 and IGFBP-3 levels were transformed to standard deviation score (SDS). Using the -2 SDS as a cut-off level to differentiate between GHD and NVSS, the diagnostic value of IGF, as well as IGFBP-3, showed sensitivity 100 per cent, specificity 66.7 per cent, and accuracy 80 per cent. The combined use of IGF-1 and IGFBP-3 < -2 SDS improved the diagnostic value with sensitivity 100 per cent, specificity 77.8 per cent, and accuracy 86.7 per cent. We concluded that the serum concentrations of IGF-1 and IGFBP-3 could reflect endogenous GH secretion and could be used as a screening evaluation of GH status in short children.

Serum insulin-like growth factor-1 (IGF-I) and insulin-like growth factor binding protein-3 (IGFBP-3) in healthy Thai children and adolescents: relation to height, weight, and body mass index.

The objective of this study was to evaluate the correlation between serum concentrations of insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3) and growth parameters (height, weight, and body mass index) in 260 healthy children and adolescents aged 5-20 years. The subjects were divided into 2 groups according to the age achieving final height. Group 1 included children with active growth consisting of girls aged under 14 years (N = 80) and boys aged under 16 years (n = 74). Group 2 included adolescents who achieved final height consisting of females aged at and over 14 years (n = 82), and males aged at and over 16 years (n = 24). In group 1, the serum concentrations of IGF-1 and IGFBP-3 were significantly positive correlated with all growth parameters. In group 2, although the correlation was insignificant, the concentrations of IGF-1 and IGFBP-3 seemed to be greater in individuals who were relatively taller and had lean body mass than those who were relatively short and over average body mass.

Serum insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) in healthy Thai children and adolescents: relation to age, sex, and stage of puberty.

The authors studied the serum concentrations of insulin-like growth factor-1 (IGF-1) and IGF-binding protein-3 (IGFBP-3) in 260 healthy children and adolescents (115 males, 145 females) aged 5-20 years. The subjects were divided into 12 groups according to age and sex. The serum IGF-1 and IGFBP-3 concentrations increased with age and peaked at age 13-15 years in males, and 11-13 years in females. After the peak concentration, IGF-1 and IGFBP-3 levels declined significantly in males, but were still high in females. Comparing between sexes, the concentrations of IGF-1 and IGFBP-3 were greater in females than males in all age groups. However, when subjects were divided according to the stage of puberty, the different concentrations between sexes were not significant, except for children within Tanner stage V where concentrations of IGF-1 and IGFBP-3 were significantly greater in females than males. Multiple regression analysis demonstrated the age, sex, and stage of puberty-dependent of IGF-1 concentration, and only the age and sex-dependent of IGFBP-3 concentration.

Goiter in Thai schoolchildren: study in Hat Yai, southern Thailand.

Examination for goiter was performed in 6,035 schoolchildren (2,899 girls, 3,136 boys), aged 8-17 years, from primary and secondary schools in Hat-Yai municipality, Songkhla province. Goiter was detected in 355 children (combined prevalence 6%; 232 or 8% in girls, 123 or 4% in boys). Of the 355 children with goiter, 214 (60%; 148 girls, 66 boys) participated in the study, and had blood drawn for free thyroxine (FT4), triiodothyronine (T3), thyroid stimulating hormone (TSH), and thyroid antibodies. All had urine collected for iodine excretion. The diagnoses of goiter were as follows: simple goiter in 192 (89.8%; 129 girls, 63 boys); juvenile autoimmune thyroiditis in 18 (8.4%; 16 girls, 2 boys); Graves' disease in 2 girls (0.9%); thyroid adenoma in 1 boy (0.45%), and ectopic thyroid in 1 girl (0.45%). Acquired hypothyroidism was found in 4 out of 18 children with juvenile autoimmune thyroiditis (22.2%). Iodine deficiency disorder was not evident in children examined shown by high urinary iodine excretion of more than 50 mcg/gm creatinine (mean 298, range 70-630). In conclusion, simple goiter is a common occurrence in children and adolescents in Southern Thailand. Juvenile autoimmune thyroiditis should be identified and differentiated from simple goiter as it is the most common cause of acquired hypothyroidism. Iodine deficiency is not evident in Southern Thailand, at least in the urban areas of a large city.