PT - JOURNAL ARTICLE AU - H Mitchell AU - M T Dattani AU - V Nanduri AU - P C Hindmarsh AU - M A Preece AU - C G D Brook TI - Failure of IGF-I and IGFBP-3 to diagnose growth hormone insufficiency AID - 10.1136/adc.80.5.443 DP - 1999 May 01 TA - Archives of Disease in Childhood PG - 443--447 VI - 80 IP - 5 4099 - http://adc.bmj.com/content/80/5/443.short 4100 - http://adc.bmj.com/content/80/5/443.full SO - Arch Dis Child1999 May 01; 80 AB - BACKGROUND Growth hormone insufficiency (GHI) is diagnosed conventionally by short stature and slow growth, and is confirmed by diminished peak GH response to a provocation test. Insulin-like growth factor I (IGF-I) and IGF binding protein 3 (IGFBP-3) have previously been considered individually OBJECTIVE To test the hypothesis that the combined analysis of IGF-I and IGFBP-3 could act as a surrogate marker for the diagnosis of GHI. DESIGN Reference ranges for IGF-I and IGFBP-3 were calculated using 521 normal individuals. A retrospective analysis was performed on 318 children referred for investigation of short stature. RESULTS No significant difference was found between either the IGF-I or IGFBP-3 standard deviation scores (SDSs) in children with and without GHI. If the requirement were for both tests to be positive (< −2 SDS) for a diagnosis of GHI, then 99% of children without GHI would be correctly identified; however, the sensitivity of the test was only 15%. CONCLUSIONS Neither IGF-I nor IGFBP-3 alone is a marker for GHI. In addition, they cannot be used as an effective screening test in combination.