Efficacy of Short-Term Growth Hormone Treatment in Prepubertal Children with Idiopathic Short Stature

PURPOSE: It has been reported that daily recombinant human growth hormone (GH) treatment showed beneficial effects on growth in prepubertal children with idiopathic short stature (ISS). The present study aimed to validate the GH (Eutropin(R)) effect on growth promotion and safety after short-term GH treatment. MATERIALS AND METHODS: This study was an open-label, multicenter, interventional study conducted at nine university hospitals in Korea between 2008 and 2009. Thirty six prepubertal children with ISS were enrolled in this study to receive 6-month GH treatment. Yearly growth rate, height standard deviation score (SDS), and adverse events were investigated during treatment. RESULTS: After 26 weeks of GH treatment, the height velocity significantly increased by 6.36+/-3.36 cm/year (p<0.001). The lower end of one-sided 95% confidence interval was 5.22 cm/year, far greater than the predefined effect size. The gain in height SDS at week 26 was 0.57+/-0.27 (p<0.0001). Bone age significantly increased after GH treatment, however, bone maturation rate (bone age for chronological age) showed limited advancement. This 26-week GH treatment was effective in increasing serum levels of insulin-like growth factor (IGF)-I and IGF binding protein (IGFBP)-3 from baseline (p<0.0001). Eutropin was well tolerated and there were no withdrawals due to adverse events. No clinically significant changes in laboratory values were observed. CONCLUSION: This 6-month daily GH treatment in children with ISS demonstrated increased height velocity, improved height SDS, and increased IGF-I and IGFBP-3 levels with a favorable safety profile.

Adipokines, insulin-like growth factor binding protein-3 levels, and insulin sensitivity in women with polycystic ovary syndrome

BACKGROUND/AIMS: Many women with polycystic ovary syndrome (PCOS) exhibit insulin resistance. Adipose tissue plays an important role in insulin resistance, and adipokines including tumor necrosis factor (TNF)-alpha and adiponectin are altered in PCOS. Insulin-like growth factor binding protein-3 (IGFBP-3), alone or in conjunction with other adipokines, is also associated with insulin resistance. We evaluated the effects of TNF-alpha, adiponectin, and IGFBP-3 on insulin sensitivity and the relationships among these proteins in women with PCOS. METHODS: We recruited 40 women with PCOS and 40 age- and body mass index (BMI)-matched regular cycling women (controls). The women were divided into obese (BMI > or = 25 kg/m2) and nonobese (BMI < 25 kg/m2) groups. Anthropometric measurements were performed, and serum levels of TNF-alpha, adiponectin, and IGFBP-3 were determined. Insulin sensitivity was estimated using the metabolic clearance rate (MCR) of glucose calculated from the oral glucose tolerance test. RESULTS: Serum levels of TNF-alpha and IGFBP-3 did not differ between the PCOS and control groups, but adiponectin levels in the PCOS group were lower than those in control women in the nonobese group (p < 0.05). TNF-alpha, adiponectin, and IGFBP-3 levels were not correlated with each other in women with PCOS, but a significant positive correlation was observed between adiponectin levels and MCR (p < 0.05). Multiple regression analysis revealed that adiponectin levels were significantly associated with insulin sensitivity (p < 0.05) in women with PCOS. CONCLUSIONS: IGFBP-3 and TNF-alpha levels were not associated with insulin sensitivity, but adiponectin levels were related to insulin sensitivity in women with PCOS.

Early aggressive parenteral nutrition induced high insulin-like growth factor 1 [IGF-1] and insulin-like growth factor binding protein 3 [IGFBP3] levels can prevent risk of retinopathy of prematurity

To evaluate early aggressive vs. conservative nutrition and its effect on Retinopathy of Prematurity [ROP] in <32 weeks of gestation neonates. A prospective, randomized, clinical study was conducted in NICU with a total of 75 preterm infants. In the intervention group, infants received early aggressive nutrition immediately after birth, in the control group infants were started on conventional parenteral nutrition [PN]. Blood samples were obtained for Insulin-like growth factor 1 [IGF-1] and insulin-like growth factor binding protein 3 [IGFBP3] levels before commencement of PN on the first postnatal day, and from week 1 to 6 every week. All the infants were examined for ROP. Infants in the early aggressive group had a reduction in the risk of ROP of 5% [2 from 40]; the number of infants needed treatment averaged 3.7 [2.7 to 5.2]. A total of 11 neonates in the conventional group were detected having ROP [P<0.05]. Overall, IGF-I levels were higher in the aggressive PN [APN] vs the conventional PN [CPN]. ROP development was higher in the CPN compared to the APN. IGF-1levels were lower in ROP developers compared with non-ROP in the APN group. There was no difference in IGF-I levels in ROP developers versus non-ROP in the CPN group. IGF-1 levels were lower in the CPN group compared with the APN group in the third week in ROP developers. There was a correlation between ROP and IGF-1 levels. Through ROC analysis, IGF-1 was demonstrated as being a sensitive marker for ROP. IGF-1 levels were higher in the APN group versus the CPN group. This may indicate that IGF-1 levels simply being higher is not enough; rather, that being higher above a cutoff value may prevent ROP

Insulin-like growth factor binding protein-3 in preterm infants with retinopathy of prematurity.

Background: Retinopathy of prematurity (ROP) is the main cause of visual impairment in preterm newborn infants. Objective: This study was conducted to determine whether insulin-like growth factor binding protein -3 (IGFBP-3) is associated with proliferative ROP and has a role in pathogenesis of the disease in premature infants. Materials and Methods: A total of 71 preterm infants born at or before 32 weeks of gestation participated in this study. Studied patients consisted of 41 neonates without vaso-proliferative findings of ROP as the control group and 30 preterm infants with evidence of severe ROP in follow up eye examination as the case group. Blood samples obtained from these infants 6-8 weeks after birth and blood levels of IGFBP-3 were measured using enzyme-linked immunosorbent assay (ELISA). Results: The mean gestation age and birth weight of the studied patients were 28.2±1.6 weeks and 1120.7±197 gram in the case group and 28.4±1.6 weeks and 1189.4±454 gram in the control group (P=0.25 and P=0.44 respectively). The infants in the case group had significantly lower Apgar score at first and 5 min after birth. Insulin-like growth factor binding protein -3 (IGFBP-3) was significantly lower in the patients with proliferative ROP than the patients without ROP [592.5±472.9 vs. 995.5±422.2 ng/ml (P=0.009)]. Using a cut-off point 770.45 ng/ml for the plasma IGFBP-3, we obtained a sensitivity of 65.9% and a specificity of 66.7% in the preterm infants with vasoproliferative ROP. Conclusion: Our data demonstrated that the blood levels IGFBP-3 was significantly lower in the patients with ROP and it is suspected that IGFBP-3 deficiency in the premature infants may have a pathogenetic role in proliferative ROP.

Inflammatory and Tumor Stimulating Responses after Laparoscopic Sigmoidectomy

PURPOSE: Laparoscopic colectomy has clinical benefits such as short hospital stay, less postoperative pain, and early return of bowel function. However, objective evidence of its immunologic and oncologic benefits is scarce. We compared functional recovery after open versus laparoscopic sigmoidectomy and investigated the effect of open versus laparoscopic surgery on acute inflammation as well as tumor stimulation. MATERIALS AND METHODS: A total of 57 patients who were diagnosed with sigmoid colon cancer were randomized for elective conventional or laparoscopically assisted sigmoidectomy. Serum samples were obtained preoperatively and on postoperative day 1. C-reactive protein (CRP) and interleukin-6 (IL-6) were measured as inflammation markers, and vascular endothelial growth factor (VEGF) and insulin-like growth factor binding protein-3 (IGFBP-3) were used as tumor stimulation factors. Clinical parameters and serum markers were compared. RESULTS: Postoperative hospital stay (p=0.031), the first day of gas out (p=0.016), and the first day of soft diet (p<0.001) were significantly shorter for the laparoscopic surgery group than the open surgery group. The levels of CRP, IL-6, and VEGF rose significantly, and the concentration of IGFBP-3 fell significantly after both open and laparoscopic surgery. However, there were no significant differences in the preoperative and postoperative levels of CRP, IL-6, VEGF, and IGFBP-3 between the two groups. CONCLUSION: Our data suggest that both open and laparoscopic surgeries are accompanied by significant changes in IL-6, CRP, IGFBP-3, and VEGF levels. Acute inflammation markers and tumor stimulating factors may not reflect clinical benefits of laparoscopic surgery.

The role of insulin like growth factor (IGF)–1 and IGF-binding protein-3 in diagnosis of growth hormone deficiency in short stature children.

Objective. To evaluate the role of IGF-1 and IGFBP-3 in diagnosis of short stature children and adolescents in whom Growth Hormone Deficiency (GHD) was found. Methods. In this cross sectional study the referred short stature children and adolescents to Namazi Hospital in Shiraz- Iran, in 2003-2005 were studied. The inclusion criteria were proved short stature based on the physical examination, weight, height, standard deviation score (SDS) of height < -2 , with considering stage of puberty and predicted height in children without any genetic or chronic disorders. The exclusion criteria were any positive physical or laboratory data suggesting hypothyroidism, rickets or liver disorders. For all patients a provocative growth hormone test was performed with propranolol and L-dopa and serum IGF-1 and IGFBP-3 were measured. GHD defined as peak(cutoff ) serum GH level under 10 ìg/L and low IGF-1 and IGFBP-3 considered as cutoff serum level under -2 standard deviation. Results. Eighty one short stature patients (39 boys and 42 girls) with mean age of 10.6 ± 3.5 years completed the study. Seventeen patients with GHD were found and in 18 patients IGF-1 level were low. Only in 6 patients both GH and IGF-1 were low and 2 of them had low IGFBP-3. There were no correlations between the levels of GH,IGF-1 and IGFBP-3 in children with short stature due to GHD. The sensitivity and specifity of IGF-1 and IGFBP-3 in assessment of GHD were 35% and 81% for IGF-1 and 12% and 94% for IGFBP-3, respectively. Conclusion. No correlations were found between GH level and serum levels of IGF-1 and IGFBP-3 in short patients and the sensitivity of these tests in assessment of GHD was poor.

Influence of Gender on Serum Growth Hormone, Insulin-Like Growth Factor-I and Its Binding Protein-3 during Aging

PURPOSE: The serum concentrations of insulin-like growth factors-I (IGF-I), insulin-like growth factor binding protein-3 (IGFBP-3) and growth hormone (GH) are related to body composition, function and metabolism, and are influenced by the aging process. This study was to investigate the influence of gender on serum concentrations of IGF-I, IGFBP-3 and GH in middle and old age subjects. MATERIALS AND METHODS: Sixty healthy volunteers (male 35, female 25, 36-70 years) were divided into 50 years groups, based on gender. Women > 50 years were post-menopause. IGF-I, IGFBP-3, and GH were determined by immunoradiometric assay. RESULTS: IGF-I was shown to be negatively correlated with age (women r = -0.62, p 50 years showed a significant reduction in IGF-I values than women 50 years showed smaller IGF-I/IGFBP-3 molar ratios (0.177998 +/- 0.039404) than men of same age group (0.228326 +/- 0.050979, p < 0.01) and women < or = 50 years (0.247667 +/- 0.069411, p < 0.01). Age was shown to positively correlate with GH/IGF-I (r = 0.49, p < 0.05) and GH/IGFBP-3 ratios (r = 0.40, p < 0.05) in women. CONCLUSIONS: The influence of aging on serum concentrations of IGF-I is more remarkable in women than in men. Menopause causes reduction of IGF-I/IGFBP-3 molar ratio. Women have the trend of progressive hypoactivity of GH to stimulate IGF-I and IGFBP-3 secretions with age.

Analysis of Serum Levels of Anti-Mullerian Hormone, Inhibin B, Insulin-Like Growth Factor-I, Insulin-Like Growth Factor Binding Protein-3, and Follicle-Stimulating Hormone with Respect to Age and Menopausal Status

This study was undertaken to investigate age-dependent and postmenopausal changes in the serum levels of anti-Mullerian hormone (AMH), inhibin B, insulin-like growth factor (IGF)-I, IGF-binding protein-3 (IGFBP-3), and follicle-stimulating hormone (FSH), and to determine which of these markers best reflects the aging process in women. A total of 144 women aged 20-59 yr were enrolled in this cross-sectional study. Blood samples were obtained on cycle day 3 of regularly menstruating women (n=111), or at random in postmenopausal women (n=33). Data were analyzed with respect to premenopausal women age groups and compared in pre- and postmenopausal women. Area under the receiver operating characteristic curve (ROCAUC) analyses were performed to assess the ability of each marker to discriminate between the pre- and postmenopausal status. Serum levels of AMH, IGF-I, and IGFBP-3 decreased and serum levels of FSH increased significantly with age in premenopausal women. Serum luteinizing hormone (LH) was higher and inhibin B was lower in women in their 20-30's than in 40's. Serum levels of AMH and IGF-I showed a consistent decrease with all age groups. ROCAUC analysis showed that the diagnostic accuracy of AMH for menopausal status was similar to those of FSH, LH, and inhibin B, and was better than that of IGF-I. In conclusion, the serum AMH level appears to be the best marker of the aging process in premenopausal women.

Effect of liver cirrhosis on circulating insulin-like growth factor binding protein-3 ternary complex

Insulin-like growth factor-1 [IGF-I], an anabolic hormone synthesized by the liver upon stimulation by growth hormone [GH], exerts important effects on nitrogen balance, bone metabolism, glucose metabolism and renal hemodynamics. IGF binding protein-3 [IGFBP-3] binds nearly 95% of circulating IGF, forming a stable ternary complex. Study the changes in circulating serum levels of IGF-l and IGFBP-3 in patients with liver cirrhosis and possible relations of these changes to the degree of liver affection. According to modified Child-Pugh [CP] classification of liver cirrhosis. 86 patients were divided into group A: 28 patients with CP class-A [score 5-6]; group B: 28 patients with CP class B [score 7-9]; and group C: 30 patients with CP class C [score 10-15]. In addition, 20 healthy age- and sex-matched volunteers served as a control group. Diagnosis of cirrhosis was based on clinical, laboratory, ultrasonographic and upper gastro-intestinal endoscopy findings. Jaundice, encephalopathy, lower limb edema/ascites, and history of hematemesis/melana were significantly more observed in moderate and severe forms of cirrhosis. In addition, liver function tests were significantly more impaired in severe cases of liver cirrhosis except AST and ALP which showed nonsignificant differences among the 3 groups of liver cirrhosis. IGF-I and IGFBP-3 were observed to be significantly decreased with the progression of liver cirrhosis. A strong negative correlation was found between IGF-I and IGFBP-3 on one side and total bilirubin, PT, INR and CP score on the other side. On the other hand, both IGF-I and IGFBP-3 correlate positively with serum albumin. The changes in the level of IOP-I and its binding protein [IGFBP-3] correlates with the degree of liver affection due to cirrhosis and can be used as a prognostic tool. Yet larger scale studies are still needed

Validity of IGF-1, IGF binding protein-3 and their ratios with prostate-specific antigen [PSA] in the clinical diagnosis of patients with prostate cancer

This study was done aiming to evaluate the validity of IGF-1, IGFBP-3 and thereof ratios with prostate specific antigen [PSA] in diagnosis of prostate cancer. The study included 60 prostate cancer patients, 44 benign prostatic hyperplasia [BPH] patients and 40 normal male subjects. Serum levels of IGF-1, IGFBP-3, PSA and fPSA were quantified. The possible associations between parameters were assessed. The validity [sensitivity and specificity] were evaluated by ROC curve analysis. The areas under curve [AUC] were 0.88, 0.81, 0.57, 0.59 and 0.62 for PSA, free/total PSA, IGF-1, IGFBP-3 and IGF-1/IGFBP-3 respectively. IGFBP-3/PSA ratio offered a high validity with an AUC of 0.87, whereas IGF-1 /PSA ratio offered the best sensitivity to specificity ratio [0.89]. IGF-1 had no significant differences between studied groups while, IGF-1/PSA ratio was found to differentiate significantly among metastatic, localized prostate cancer and control groups. A significance difference was noted for IGFBP-3/PSA ratio between prostate cancer and control groups. From our study it can be concluded that serum IGF-1 and IGFBP-3 may have no ability merely by themselves to discriminate prostate cancer, but their combinations with PSA proved to be valid tool for the significant discrimination of prostate cancer as well as reflecting the progression of the disease

Reference intervals for important serum sex steroid hormones, prostate specific antigen, insulin like growth factor 1 and IGF binding protein 3 concentration in a normal Kuwaiti adult male population

The purpose of this study was to determine the age-specific reference ranges for some important male sex steroid hormones, prostate-specific antigen [PSA], insulin-like growth factor-1 [IGF-1], and IGF binding protein-3 [IGFBP-3], for the Kuwaiti population. Blood samples were taken from 398 consenting, fasting, healthy Kuwaiti males aged 15-80 years between 8.00 a.m. and 12.00 noon. The serum concentrations of total testosterone [TT], dehydro-epiandrosterone sulfate [DHEAS], androstenedione [ADT], sex hormone binding globulin, luteinizing hormone [LH], follicle-stimulating hormone [FSH], prolactin, PSA, IGF-1 and IGFBP-3 were determined. A distribution curve was plotted and age-specific reference levels were determined for each analyte. The reference interval for parameters with a normal distribution [Gaussian] was mean +/- 2 SD, while for the non-normal distribution [non-Gaussian], it was 2.5-97.5 percentile. The reference intervals for the analytes obtained from this study were compared with those suggested by the kit manufacturers and currently used by the Ministry of Health, Kuwait Laboratories [MOHKL]. Serum IGFBP-3 and ADT had normal distribution while other analytes had non-normal distribution. The reference intervals from this study, manufacturers kit and MOHKL were as follows: TT 3-31, 9-60, 8-35 nmol/l; DHEAS 0.9-11, 1.0-7.3, 2.2- 15.2 micro mol/l; ADT 0.5-4.3, 0.8-2.8, 2.0-9.2 nmol/l; LH 1-11, 0.8-7.6, 0.4-5.7 mIU/l; FSH 0.5-11, 0.7-11.1, 1.1-13.5 mIU/l; prolactin 42-397, 53-360, 80-230 nmol/l; IGF-1 41-542, 78-956, 71-261 ng/ml; IGFBP-3 88- 2,090, 900-4,000, 900-4,000 ng/ml, and PSA 0-3.1, 0-4, 0-4 ng/ml, respectively. These data indicate that for Kuwaitis lower reference ranges must be used for serum TT, DHEAS, ADT, IGFBP-3 and PSA. There is no need to change the currently used reference interval for FSH whereas higher values must be used for LH, prolactin, and IGF-1

Measurement of IGF-1, IGFBP-3 and free IGF-1 levels by ELISA in growth hormone (GH) deficient children before and after GH replacement.

Serum insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) levels reflect the growth hormone (GH) status. A few percent of IGF-1 circulate in a free form which is believed to represent the IGF biological activity. We retrospectively studied the changes of serum IGF-1, serum IGFBP-3, and plasma free IGF-1 levels in growth hormone deficient (GHD) children before and after treatment with recombinant human growth hormone (rhGH) for a period of 6 months and 1 year. Twenty-one GHD children (16 boys and 5 girls) who had the mean chronological and bone ages of 7.7 +/- 0.7 and 4.8 +/- 0.6 years, respectively, were treated with a mean rhGH dose of 11.66 +/- 0.42 U/m2 body surface area/week. Serum IGF-1 level increased from 162.5 +/- 42.9 ng/ml before treatment to 252.8 +/- 49.5 ng/ml (p = 0.007) and 282.7 +/- 86.9 ng/ml after treatment for 6 months and 1 year, respectively. Plasma free IGF-1 also increased from 0.38 +/- 0.30 ng/ml before treatment to 1.21 +/- 0.30 (p = 0.001) and 1.17 +/- 0.42 ng/ml after 6 months and 1 year of treatment. However, serum IGFBP-3 did not significantly increase after treatment. In addition, the free/total IGF-1 ratio decreased after treatment with rhGH. The height velocities at 6 months and 1 year after treatment were negatively correlated with plasma free IGF-1 before treatment. In conclusion, therefore, plasma free IGF-1 levels could serve as a good predictor of growth hormone responses. Furthermore, their circulating levels would be modified by serum IGF-1 status, and possibly, IGFBP-3 protease activity.

Umbilical cord blood leptin, insulin -like growth factor-1, insulin -like growth factor binding protein-3 and newborn birth weight in pre-eclampsia

The aim of this study was to determine whether newborn birth weight is correlated to IGF-1, IGFBP-3 and leptin in cases with moderate preeclampsia. This study was done cross-sectionallly and included 25 pregnant women with moderate preeclampsia [PE group] and 25 normotensive pregnant women [NT group] of similar gestational age. Umbilical cord blood levels of IGF-1, IGFBP-3 and Leptin were assessed in each group. As compared with the NT group the PE group had significantly [p<0.001] lower newborn birth weight [3.33 [ +/- 0.9] vs 2.8 [ +/- 0.7] kg]], IGF-1 [66.5 [ +/- 26.7] vs 29.5 [ +/- 14.8] ng / ml] and IGFBP-3 [1250 [ +/- 39.94] vs 911 [ +/- 63.7] ng / ml]. Leptin was shown to be significantly [p<0.001] higher in the PE group compared with NT group. Significant correlation [r=0. 79, p<0.0001] was found between serum cord IGF and newborn birth weight, using stepwise multiple regression analysis, newborn birth weight was predicted by umbilical IGF-1 [r=0.53, p<0.0001]. A significant correlation between cord blood leptin and newborn birth weight was found only in the PE group r= 0.5 [p<0.01].No differences was found among female and male newborns regarding umbilical cord leptin concentration. The present study indicates that moderate preeclampsia is associated with low birth weight. IGF-1, IGFBP-3 and high leptin levels. There was a correlation between birth weight and IGF-1 which can predict newborn birth weight. Correlation between umbilical cord leptin and birth weight was found in cases with preeclampsia with no differences between leptin levels among female and male newborns

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.

Serum insulin-like growth factor (IGF)-I and IGF-binding proteins in lung cancer patients

Many studies have shown that insulin-like growth factors (IGF-I & IGF-II) are implicated in the autocrine and paracrine growth of various tumors. Alterations in serum IGFs and IGF-binding proteins (IGFBPs) profiles have been reported in lung cancer. In this study, we measured serum levels of IGF-I and IGFBPs in 41 patients with lung cancer (small cell lung cancer, SCLC, 9; non-small cell lung cancer, NSCLC, 32) by radioimmunoassay and Western ligand blot (WLB). The serum IGF-I level in patients with lung cancer was significantly lower than in controls (207.9+/-62.6 vs 281.3+/-53.9 ng/mL, p0.05). The concentration of IGFBP-3 in lung cancer was 48% of that found in controls by WLB. The serum level of IGFBP-2 was markedly elevated in patients with lung cancer compared with controls (1303.7+/-618.0 vs 696.2+/-300.5, p<0.01). However, there was no significant difference between SCLC and NSCLC groups. This result showed that serum level of IGF-I/IGFBPs may be useful markers for diagnosing and identifying tumor types in lung cancer and further studies are needed.

Serum IGF-I and IGFBP-3 levels for normal Thai children and their usefulness in clinical practice.

Serum IGF-I and IGFBP-3 levels are growth hormone (GH) dependent and reflect the endogenous GH secretion. Two hundred and forty-four healthy children were evaluated for serum IGF-I and IGFBP-3 levels and then the age-defined normal values for Thai children were constructed. The results showed that the serum IGF-I and IGFBP-3 levels were age dependent, gradually increased from birth and reached the peak values around the age of 14-16 years. In addition, we studied the IGF-I and IGFBP-3 values in 28 GH deficient children and 26 normal variant short stature (NVSS) by using our normal constructed values as the reference. To minimize the influence of age, both IGF-I and IGFBP-3 values were transformed to standard deviation score (SDS). In clinical practice, we recommend using the IGF-I SDS and IGFBP-3 SDS of -1 and -1.3 respectively as a cut-off point to discriminate between GH deficiency and NVSS to avoid risky GH provocative tests and unnecessary GH replacement with the sensitivity of 71 per cent and the specificity of 92 per cent.

Insulin-like growth factor [IGF] -1, IGF-II, IGF-binding protein -1 [IGFBP-1] and IGFBP-3 in children with insulin dependent diabetes mellitus

The existing literature on serum insulin like growth factors [IGFs] and their binding proteins [IGFBPs] levels in insulin dependent diabetes mellitus [IDDM] is conflicting. In the present study, 44 children and adolescents with IDDM [22 newly diagnosed and 22 old known cases] aged from 5 to 14 years, 18 girls and 26 boys, together with 18 apparently healthy control children of matchable age and sex were subjected to estimation of serum levels of IGF-I, IGF II, IGFBP-1, IGFBP-3 and fasting serum glucose. Glycemic control was assessed by glycosylated hemoglobin [HbA[1C]]. Diabetic children showed significantly lower serum levels of IGF-I, IGF-II and IGFBP-3 [p<0.01, p<0.01 and p<0.001 respectively] and significantly higher levels of IGFBP-1 [p<0.05] than controls. This was true for the diabetic cases in general, for newly diagnosed cases and for those with poor metabolic control. Old diabetic cases and patients with average glycemic control differed from the control children only regarding IGF-II [p<0.001 for both] and regarding IGFBP-3 [p<0.001] and p<0.05 respectively]. While prepubertal cases showed significantly lower IGF-I than controls [p<0.05], pubertal cases lacked this difference. IGF-I levels were negatively correlated with each of HbA[1C] [r=-0.52, p<0.001] and IGFBP-1 [r=-0.45, p<0.002], and were positively correlated with each of IGFBP 3 [r=0.31, p<0.05] and body mass index [BMI] [r=0.43, p<0.004]. IGFBP-1 levels were positively correlated with fasting serum glucose [r=0.46, p<0.002]. In conclusion, alterations in the IGF/IGFBP system are observed in children with IDDM in the present study. Improvement of glycemic control may help to decrease this alteration. The impact of these alterations on the health of diabetic children is still unsettled

Expression of insulin-like growth factor-I, II and insulin-like growth factor binding protein-3 in bladder carcinoma

Insulin-like growth factors I, II [IGF-I, II] and insulin-like growth factor binding protein-3 were estimated in the sera of 22 subjects suffering from bladder carcinoma and 25 subjects selected as a control group by using IRMA kits. Also, histological examination of the surgical specimen of the cancer bladder patients was done. The results showed that all patients had squamous cell carcinoma and were subdivided into grade II [n = 16] and grade III [n = 6]. IGF-I, IGF- II and IGFBp-3 were significantly higher in sera of bladder carcinoma patients compared with the control group. Serum levels of IGF-II were correlated positively with the grading of the bladder cancer, where IGF-II serum levels in grade III carcinoma were significantly higher than that in grade II carcinoma. On the other hand, neither IGF-I nor IGFBp-3 correlated with the grades of tumor

Insulin-like growth factor-I, insulin-link growth factor binding protein-3 and insulin in normal and high risk neonates

This study included ten preterm infants, ten infants with respiratory distress [RD], eight infants of deliveries with premature rupture of membrane [PROM] and septicemia, eight infants with intrauterine growth retardation [IUGR] and sixteen infants of diabetic mothers together with ten normal full term infants representing the control group. Blood sample was obtained within 12 hours after delivery, sera were used for determination of IGF-I, IGFBP-3 and insulin. The study revealed significantly decreased levels of IGF-I, IGFBP-3 and insulin in preterm infants, infants with RD, PROM and septicemia compared with control group. However, in infants with IUGR IFF-I showed slight increase, while IGFBP-3 exhibited slight decrease and insulin was significantly decreased compared with controls. In infants of diabetic mothers, both IGF-I and insulin levels were significantly increased compared with control infants