The usefulness of serum IGF-1 and serum IGFBP-3 for the diagnosis of growth hormone deficiency in comparison to clonidine stimulation test: a prospective cohort study


  • Hemlin Thomas C. Department of Paediatrics, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India
  • Sanjeev Kumar Department of Paediatrics, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India
  • Bisto A. A. Department of Paediatrics, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India



Growth hormone deficiency, IGF-1, IGFBP-3, Short stature


Background: Growth Hormone Deficiency is conventionally diagnosed by low peak Growth Hormone levels to provocative testing. Serum IGF-1 and IGFBP-3 are under the influence of GH and reflect the endogenous GH secretion. Owing to the absence of a circadian rhythm, it is possible to take individual measurements of IGF-1 and IGFBP-3 at any time of the day for evaluation of GH status instead of subjecting the individual to cumbersome provocative tests. Objectives of this study were to compare IGF-1 and IGFBP-3 assays with clonidine stimulation test in children of different age group with short stature.

Methods: 90 children with short stature were included in the study. Samples for basal GH, IGF-1 and IGFBP-3 were obtained and afterwards all children were subjected to clonidine stimulation test. The diagnostic value of the tests were analysed in terms of sensitivity, specificity, predictive value and accuracy in younger and older age groups.

Results: 40% of the study population was diagnosed to have GHD. IGF-1 had high sensitivity in both age groups. But in the younger age group IGFBP-3 was more specific. Both the tests had same specificity in the older age group. Combining the two tests helped to improve diagnostic value in all the age groups.

Conclusions: Measurements of IGF-1 and IGFBP-3 have shown comparable diagnostic performance with growth hormone stimulation tests and are valuable for patient`s convenience and ease of performance and can be useful in the workup of growth hormone deficiency.


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