Growth Response to Growth Hormone (GH) Treatment Relates to Serum Insulin-Like Growth Factor I (IGF-I) and IGF-Binding Protein-3 in Short Children with Various GH Secretion Capacities

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Abstract
The purpose of the study was to evaluate the relationship between the 1-yr (n 5 193) and 2-yr (n 5 128) growth response and the individual serum concentrations of insulin-like growth factor I (IGF-I) and IGF-binding protein 3 (IGFBP-3) before and during GH treat- ment. Our study group of prepubertal short children had from very low to high GH secretory capacity, estimated during an arginine- insulin tolerance test, and the ages ranged from 3-15 yr at the start of treatment. Their serum levels of IGF-I and IGFBP-3 were low before treatment compared to those in an age-related reference group of prepubertal children and increased significantly from the start to 1 month of GH treatment. The mean increase in height SD score was 0.80 SD score after 1 yr of GH treatment and 1.26 SD score after 2 yr, with a wide range. In univariate analyses the highest correlation coefficients to the 2-yr growth response were found to be vs. the following variables from the start of treatment: IGF-I SD score (r 5 20.49), log maximum GH concentration (log GHmax) during the argi- nine-insulin tolerance test (r 52 0.47), difference between the height SD score of the individual child and the midparental height SD score (diffSD score; r 52 0.45), IGFBP-3 SD score (r 52 0.39), age (r 5 20.30), short term change in IGFBP-3 SD score (r 5 0.37), and IGF-I SD score (r 5 0.34). In multivariate stepwise regression analysis, 41% of the variation in the 2-yr growth response could be explained by IGF-I SD score or log GHmax together with age at the start of treat- ment, weight SD score at 1 yr of age, and diffSD score. When both IGF-I SD score and GHmax were included and when the short term changes in IGF-I SD score were added, 46% and 58% of the variation, respec- tively, could be explained. The regression algorithms using different combinations of variables and their corresponding prediction inter- vals are also presented. (J Clin Endocrinol Metab 82: 2889 -2898, 1997)

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