Biochemical diagnostic strategies in the evaluation of short stature: the diagnosis of insulin-like growth factor deficiency

Hormone Research
R G Rosenfeld

Abstract

The cornerstones in the evaluation of short stature are auxology and biochemical testing. Traditionally, the diagnosis of growth hormone (GH) deficiency has been based upon measurement of serum concentrations of GH following either physiological or pharmacological stimulation, or determination of spontaneous GH secretory patterns. Assessment of pituitary GH secretion is, however, fraught with problems, including the nonphysiological nature of provocative testing, the reliance on arbitrary definitions of subnormal responses, the inadequate attention paid to age- and puberty-related variability, and the dependence upon assays with marginal concordancy. It is proposed that the evaluation of short stature is best pursued by careful auxology plus assessment of the insulin-like growth factor (IGF) axis, with particular attention to measurements of serum concentrations of IGF-I and IGF-binding protein-3. The diagnosis of IGF deficiency can then be readily established, and its etiology pursued logically.

Citations

Feb 1, 2005·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Ross G Clark
Apr 15, 2008·Trends in Endocrinology and Metabolism : TEM·F de ZegherP Chatelain
Jun 1, 2012·FASEB Journal : Official Publication of the Federation of American Societies for Experimental Biology·Elisabeth R BartonYair Argon
Dec 24, 1997·Acta Paediatrica. Supplement·R G Rosenfeld
Sep 1, 2009·Endocrinology and Metabolism Clinics of North America·George M BrightRon G Rosenfeld
Aug 15, 2015·Journal of Orofacial Orthopedics = Fortschritte Der Kieferorthopädie : Organ/official Journal Deutsche Gesellschaft Für Kieferorthopädie·Mohamed I MasoudNour F Gowharji
Aug 10, 2017·Hormone Research in Pædiatrics·Dina A SchottConstance T R M Stumpel
May 4, 2010·Journal of Pediatric Endocrinology & Metabolism : JPEM·P BackeljauwR Rosenfeld
Oct 9, 2020·Reviews in Endocrine & Metabolic Disorders·Vivian HwaRon G Rosenfeld

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