Evaluation of Insulin-Like Growth Factor-1 and Its Impact on GrowthHormone Therapy in Growth Hormone-Deficient Indian Children

Background: insulin-like growth factor-1 (igf-1) and igf-binding protein 3 (igfbp-3) are used widely for evaluating growth hormone deficiency (ghd). we evaluated the effect of recombinant human growth hormone treatment on serum igf-1 concentrations in indian children with ghd over a period of 24 months. patients and methods: patients who presented with short stature were evaluated. the enrolled subjects exhibited a height standard deviation score (sds) of less than -3 and/ or a height velocity sds of less than -2 over a 12-month period, and they displayed gh concentrations of less than 10 ng/ml in 2 provocative tests. patients received a detailed physical examination that included auxology, pubertal staging, and biochemical assays to measure igf-1 concentration. all patients received gh at a dose of 0.3 mg/kg/week in 7 divided doses subcutaneously daily at night. patients with multiple pituitary hormone deficiencies received additional substitution therapy. results: twenty-five prepubescent children (male:female = 14:11) at a mean age of 8.6 ± 2.9 years were enrolled. the height sds at baseline, 1 year, and 2 years was -5.38 ± 1.4, -4.10 ± 1.4, and -3.6 ± 1.3, respectively (p < 0.005), whereas the igf-1 sds at baseline, 1 year, and 2 years was -3.40 ± 0.8, -1.74 ± 1.2 and, -1.54 ± 1.7, respectively (p > 0.1). no significant difference in height change sds was detected between children with an igf-1 sds in the normal range and children with an igf-1 sds of less than -2 at 2 years. bone age advancement, the occur- rence of puberty, and levels of fasting glucose and hba1c did not change during therapy. conclusions: our study on indian children indicates that changes in serum igf-1 sds con- centrations may not be a reliable marker for responsiveness to gh therapy.