AffiliationDepartment of Endocrinology, Salford Royal NHS Foundation Trust, UK. email@example.com
MetadataShow full item record
AbstractThe GH/IGF1 system, like other endocrine systems, is dynamic and its activity changes with age and sexual maturation, and is influenced by body composition and other factors. A normal level of IGF1 does not exclude a diagnosis of GH deficiency (GHD) in adults, and the usefulness of IGF1 in the diagnosis of adult GHD has historically been confusing and contentious. The regulation of IGF1 secretion in adults is complex, and is not solely dependent on GH status with factors recognized to influence IGF1 status in patients with GHD including age, gender, exogenous estrogen therapy, prolactin status, and severity of GHD. The usefulness of IGF1 for monitoring treatment of GH disorders in adulthood is now widely accepted, especially as GH-dosing regimens for GHD have evolved from weight-based dosing (associated with overtreatment and side effects) to individualized dose-titration strategies, which maintain IGF1 within target limits. Sub-optimal replacement therapy may be associated with morbidity and mortality risk from a continuing state of functional GHD. Conversely, avoiding iatrogenic biochemical acromegaly is clearly important and other potential safety issues may be associated with a persistently high IGF1. Analysis and interpretation of IGF1 status therefore represent a useful diagnostic tool especially in the younger adult patients with severe GHD and an essential measurement for monitoring GH replacement in all adults with GHD. High-quality, method-specific reference ranges for IGF1 and a high degree of methodological consistency in the assay are essential for reliable comparison of results.
CitationThe value of IGF1 estimation in adults with GH deficiency. 2009, 161 Suppl 1:S33-9 Eur. J. Endocrinol.
JournalEuropean Journal of Endocrinology
- Prolactin deficiency is independently associated with reduced insulin-like growth factor I status in severely growth hormone-deficient adults.
- Authors: Mukherjee A, Ryder WD, Jöstel A, Shalet SM
- Issue date: 2006 Jul
- Growth hormone (GH) provocative retesting of 108 young adults with childhood-onset GH deficiency and the diagnostic value of insulin-like growth factor I (IGF-I) and IGF-binding protein-3.
- Authors: Juul A, Kastrup KW, Pedersen SA, Skakkebaek NE
- Issue date: 1997 Apr
- Optimizing growth hormone replacement therapy by dose titration in hypopituitary adults.
- Authors: Drake WM, Coyte D, Camacho-Hübner C, Jivanji NM, Kaltsas G, Wood DF, Trainer PJ, Grossman AB, Besser GM, Monson JP
- Issue date: 1998 Nov
- Impact of different cut-off limits of peak GH after GHRH-arginine stimulatory test, single IGF1 measurement, or their combination in identifying adult patients with GH deficiency.
- Authors: Bogazzi F, Manetti L, Lombardi M, Giovannetti C, Raffaelli V, Urbani C, Scattina I, Pepe P, Iannelli A, Martino E, Rossi G
- Issue date: 2011 May
- Response to GH treatment in adult GH deficiency is predicted by gender, age, and IGF1 SDS but not by stimulated GH-peak.
- Authors: Feldt-Rasmussen U, Brabant G, Maiter D, Jonsson B, Toogood A, Koltowska-Haggstrom M, Rasmussen AK, Buchfelder M, Saller B, Biller BM
- Issue date: 2013 May