Impact of the Choice of IGF-I Assay and Normative Dataset on the Diagnosis and Treatment of Growth Hormone Deficiency in Children

Maarten A.C. Broeren, Johannes G. Krabbe, Lianne S. Boesten, Anita C.S. Hokken-Koelega, Yolanda B. De Rijke

Onderzoeksoutput: Bijdrage aan tijdschriftTijdschriftartikelAcademicpeer review

6 Citaten (Scopus)

Samenvatting

Background: The analysis of insulin-like growth factor I (IGF-I) is an important tool for pediatricians in the diagnosis and treatment of growth hormone deficiency in children. However, significant differences exist in IGF-I assays and normative datasets, which can have important clinical consequences. Methods: IGF-I analyses were performed using the IDS-iSYS platform on 1,897 samples from pediatric patients (0.5-18 years old). Z-scores were calculated based on normative IGF-I data from Bidlingmaier et al. (SD-BM) [J Clin Endocrinol Metab. 2014 May; 99(5): 1712-21] and normative IGF-I data from the IGF-I harmonization program in the Netherlands (SD-NL). The differences in Z-scores were analyzed at relevant clinical decision points (-2 SD, +2 SD). These normative datasets were also compared to normative data reported by Elmlinger et al. [Clin Chem Lab Med. 2004; 42(6): 654-64]. Results: The difference in Z-score between SD-BM and SD-NL was highest in males between 0 and 3 years old, exceeding 2 SD. Clinically relevant discordance between both Z-scores at-2 and +2 SD was found in 12.7% of all samples. The IGF-I levels at-2 and +2 SD reported in the normative dataset of Elmlinger et al. were up to 100% higher than the IGF-I levels reported by Bidlingmaier et al. or the Dutch harmonization program. Conclusion: Pediatricians and laboratory specialists should be aware of relevant differences that can exist between IGF-I assays and normative data. Well-defined pediatric reference ranges for the IDS-iSYS platform are highly desirable.

Originele taal-2Engels
Pagina's (van-tot)181-189
Aantal pagina's9
TijdschriftHormone Research in Paediatrics
Volume90
Nummer van het tijdschrift3
DOI's
StatusGepubliceerd - 1 nov. 2018

Financiering

aDepartment of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; bDepartment of Clinical Chemistry, Máxima Medical Center, Veldhoven-Eindhoven, The Netherlands; cDepartment of Clinical Chemistry and Laboratory Medicine, Medisch Spectrum Twente, Medlon BV, Enschede, The Netherlands; dDepartment of Clinical Chemistry, Ysselland Ziekenhuis, Capelle aan de IJssel, The Netherlands; eDutch Growth Research Foundation, Rotterdam, The Netherlands; fDepartment of Pediatrics, Subdivision of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands This study was approved by the Medical Ethics Committee of the Erasmus Medical Center (Rotterdam, The Netherlands).

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