Significance of basal IGF-I, IGFBP-3 and IGFBP-2 measurements in the diagnostics of short stature in children

The role of IGF-I and IGFBP-3 measurements in the diagnostic work-up of sho rt children is established but remains controversial. Little information ex ists on the value of IGFBP-2 measurements. Based on reference data establis hed in 388 children we have reinvestigated the issue, using data from 392 s hort children who underwent the same diagnostic procedures between 1987 and 1998 (GHD, n = 187; non-GHD, n = 205, including patients with ISS, n = 76; IUGR, n = 46; and TS, n = 83). In comparing IGF-I, IGFBP-3 and IGFBP-2 ser um levels of GHD and ISS children with reference data, we calculated the se nsitivity, specificity, efficiency and positive predictive value for the di agnosis of GHD. The overall sensitivity of the parameters was high, the ran k order being as follows: IGF-I >IGFBP-3 >IGFBP-2 (75, 67 and 62%, respecti vely). In contrast, the specificity was relatively low: IGFBP-3 >IGFBP-2 >I GF-I (50, 50 and 32%, respectively). The efficiency and positive predictive value of parameters was in the order of 40, 60 and 70-80%, respectively. I n repeated measurements, the recorded basal levels of IGF-I and IGFBP-3 sho wed an overall narrow range of variation. We conclude that the determinatio n of basal IGF parameters is, together with anthropometry and imaging techn iques, an indispensable tool for differentiating between GHD and ISS; and t hat IGFBP-2 plays an additional role in this process. Copyright (C) 2001 S. Karger AG, Basel.