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Liu Z, Zhao X, Liu Y, Shi L, Wu L, Yuan H, Jin Y. Development of an insulin-like growth factor-1 certified reference material by SI-traceable isotope-dilution mass spectrometry. Talanta 2024; 273:125812. [PMID: 38452589 DOI: 10.1016/j.talanta.2024.125812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/29/2024] [Accepted: 02/17/2024] [Indexed: 03/09/2024]
Abstract
In this study, an insulin-like growth factor-1 (IGF-1) certified reference material (CRM) was developed by the National Institute of Metrology (NIM), and two different principles for evaluating the IGF-1 CRM were established. After optimisation of the acid hydrolysis conditions (110 °C, 36 h), quantitative determination of peptide purity, and chromatographic separation and mass spectrometric detection, amino acid analysis-based high-performance liquid chromatography combined with isotope-dilution tandem mass spectrometry (AAA-HPLC-IDMS/MS) and peptide analysis-based HPLC-IDMS/MS (Peptide-HPLC-IDMS/MS) were used for certified value assignment; the results obtained were 136.28 and 135.01 μg/g, respectively, which were in good agreement. These results were subjected to the normal distribution test, outlier test, and method consistency test. The homogeneity and stability of the reference materials were also examined, and the uncertainty introduced in the experimental process was calculated. The final certified value was (136 ± 15) μg g-1 (k = 2). The CRM was found to be stable for at least six months when stored at -70 °C and for 7 d when stored at higher temperatures (-20 °C, 4 °C, 25 °C, or 40 °C). The CRM is expected to be used as a primary calibrator for quality control in biopharmaceutical production and clinical diagnostics.
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Affiliation(s)
- Zihan Liu
- National Institute of Metrology, Beijing, China; Department of Clinical Laboratory, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xu Zhao
- National Institute of Metrology, Beijing, China
| | - Yahui Liu
- National Institute of Metrology, Beijing, China
| | - Lianhua Shi
- National Institute of Metrology, Beijing, China
| | - Liqing Wu
- National Institute of Metrology, Beijing, China
| | - Hui Yuan
- Department of Clinical Laboratory, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
| | - Youxun Jin
- National Institute of Metrology, Beijing, China.
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2
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Postma MR, van Beek AP, van der Klauw MM, Lentjes EGWM, Muller Kobold AC. IGF-1 as screening tool for acromegaly and adult-onset growth hormone deficiency in the Netherlands. Clin Endocrinol (Oxf) 2024; 100:260-268. [PMID: 38044875 DOI: 10.1111/cen.15000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 11/20/2023] [Accepted: 11/23/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVE Insulin-like growth factor 1 (IGF-1) measurements play a central role in the diagnosis and follow-up of acromegaly and growth hormone deficiency. However, improving health care outcomes for these patients involves an intricate process of laboratory diagnostics and skilled health care professionals. The integrated effects of IGF-1 reports on diagnosis and treatment decisions are yet unknown. DESIGN, PATIENTS AND MEASUREMENTS Extended quality assessment, distributing the description of five (real) patient cases with accompanying blood samples. Patients suspected or during follow up for acromegaly or adult onset of growth hormone deficiency were included. Laboratory specialists and endocrinologists in the same centre were asked to interpret their centre-specific IGF-1 results by using a laboratory and medical questionnaire. This way, insight could be obtained into the combined effects of different assays, assay harmonisation, reference value sets, and individual physician interpretation in relation to guidelines, thus reviewing the entire diagnostic and management process. RESULTS Limited variation (CV 13.8 ± 2.8) was found in IGF-1 concentrations despite different use of the harmonization sample and factor among laboratories. This interlaboratory variation increased upon conversion to SD scores (CV 15.7 ± 40.7) as a consequence of the use of different reference value sets. Furthermore, there was a lack of adherence to international guidelines among endocrinologists. CONCLUSIONS Highly variable diagnostic and treatment outcomes in acromegaly and AGHD in the Netherlands can be attributed to increased variability of IGF-1 upon conversion to SD scores and low adherence to clinical guidelines.
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Affiliation(s)
- Mark R Postma
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - André P van Beek
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Melanie M van der Klauw
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Eef G W M Lentjes
- Central Diagnostic Laboratory (CDL), University of Utrecht, Utrecht Medical Center, Utrecht, The Netherlands
| | - Anneke C Muller Kobold
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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3
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Huang R, Shi J, Wei R, Li J. Challenges of insulin-like growth factor-1 testing. Crit Rev Clin Lab Sci 2024:1-16. [PMID: 38323343 DOI: 10.1080/10408363.2024.2306804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/15/2024] [Indexed: 02/08/2024]
Abstract
Insulin-like growth factor 1 (IGF-1), primarily synthesized in the liver, was initially discovered due to its capacity to replicate the metabolic effects of insulin. Subsequently, it emerged as a key regulator of the actions of growth hormone (GH), managing critical processes like cell proliferation, differentiation, and apoptosis. Notably, IGF-1 displays a longer half-life compared to GH, making it less susceptible to factors that may affect GH concentrations. Consequently, the measurement of IGF-1 proves to be more specific and sensitive when diagnosing conditions such as acromegaly or GH deficiency. The recognition of the existence of IGFBPs and their potential to interfere with IGF-1 immunoassays urged the implementation of various techniques to moderate this issue and provide accurate IGF-1 results. Additionally, in response to the limitations associated with IGF-1 immunoassays and the occurrence of discordant IGF-1 results, modern mass spectrometric methods were developed to facilitate the quantification of IGF-1 levels. Taking advantage of their ability to minimize the interference caused by IGF-1 variants, mass spectrometric methods offer the capacity to deliver robust, reliable, and accurate IGF-1 results, relying on the precision of mass measurements. This also enables the potential detection of pathogenic mutations through protein sequence analysis. However, despite the analytical challenges, the discordance in IGF-1 reference intervals can be attributed to a multitude of factors, potentially leading to distinct interpretations of results. The establishment of reference intervals for each assay is a demanding task, and it requires nationwide multicenter collaboration among laboratorians, clinicians, and assay manufacturers to achieve this common goal in a cost-effective and resource-efficient manner. In this comprehensive review, we examine the challenges associated with the standardization of IGF-1 measurement methods, the minimization of pre-analytical factors, and the harmonization of reference intervals. Particular emphasis will be placed on the development of IGF-1 measurement techniques using "top-down" or "bottom-up" mass spectrometric methods.
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Affiliation(s)
- Rongrong Huang
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, USA
- Department of Pathology and Laboratory Medicine, Harris Health System Ben Taub Hospital, Houston, TX, USA
| | - Junyan Shi
- Department of Pathology and Laboratory Medicine, Vancouver General Hospital, Vancouver Coastal Health, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ruhan Wei
- Department of Pathology, Duke University School of Medicine, Durham, NC, USA
| | - Jieli Li
- Department of Pathology, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
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Lee JKY, Cradic K, Singh RJ, Jones J, Li J. Discordance of insulin-like growth factor-1 results and interpretation on four different platforms. Clin Chim Acta 2023; 539:130-133. [PMID: 36528048 DOI: 10.1016/j.cca.2022.11.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/09/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Inconsistent Insulin-like Growth Factor 1 (IGF-1) measurements among different platforms have been observed. In this study, we compared the IGF-1 assay on four different platforms. METHODS A total of 110 serum specimens were analyzed in this comparison study. IGF-1 was measured on the three different chemiluminescent automated immunoassay of Siemens Immulite 2000 XPi, DiaSorin Liaison XL, IDS iSYS and LC-MS/MS method. Results were compared with Weighted Deming regression. Bias was evaluated using the Bland-Altman method. RESULTS Weighted Deming regression analysis showed approximately 36 % negative variation on Immulite, compared to Liaison (Immulite = 0.64 * DiaSorin + 2.95, r2 = 0.95); 8 % negative variation on iSYS, compared to Liaison (iSYS = 0.92 * DiaSorin + 0.51, r2 = 0.97); 17 % negative variation on LC-MS/MS, compared to Liaison (LC-MS/MS = 0.83 * DiaSorin-11.23, r2 = 0.93); 34 % positive variation on LC-MS/MS compared to Immulite (LC-MS/MS = 1.34 * Immulite-21.97, r2 = 0.96); 81 % positive variation on IDS iSYS compared to Immulite (IDS iSYS = 1.81 * Immulite-117.65, r2 = 0.83). The Bland-Altman plot showed a significant negative variation of Immulite versus DiaSorin and positive variation of IDS iSYS versus Immulite. Overall agreement between different platforms was poor, which reflected systematic difference. The variation between platforms increased as IGF-1 values increased. CONCLUSIONS There are wide variations between different platforms for IGF-1 measurement. The lack of standardization in IGF-1 measurement creates a challenge for clinicians to monitor IGF-1 and treat patients with pituitary disorders, when switching from one platform to another. The potential impact of the variations in IGF-1 measurement between different platforms should be taken into consideration when managing patients.
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Affiliation(s)
- Jason K Y Lee
- Department of Clinical Laboratory, University Hospital, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Kendall Cradic
- OhioHealth Laboratory Services, Department of Pathology, OhioHealth, Columbus, OH, United States; CORPath Pathology Services, LLC, Columbus, OH, United States
| | - Ravinder J Singh
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - JoAnna Jones
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, United States.
| | - Jieli Li
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, United States.
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Puvilland C, Villanueva C, Hemmendinger A, Kornreich L, Gueorguieva I, Karnoub MA, Beuriat PA, Leblond P. Growth Hormone Replacement Therapy Seems to Be Safe in Children with Low-Grade Midline Glioma: A Series of 124 Cases with Review of the Literature. Cancers (Basel) 2022; 15:cancers15010055. [PMID: 36612052 PMCID: PMC9817711 DOI: 10.3390/cancers15010055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/10/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
There is little scientific evidence regarding the safety of GHRT in LGG, where GH deficiency is common. PURPOSE to compare the recurrence rate in children with midline LGG, depending on whether or not they have received GHRT, in order to assess its impact on the risk of tumor recurrence. METHODS This bicentric retrospective study included 124 patients under the age of 18 who were diagnosed with a midline low-grade glial tumor between 1998 and 2016. We also reviewed literature on this subject. The main outcome measure was tumor relapse, demonstrated by brain MRI. RESULTS There were 17 patients in the GH-supplemented group (14%) and 107 patients in the non-supplemented group (86%). Relapse occurred in 65 patients (45.5%); 7 patients died (4.9%); no deaths occurred in patients receiving GHRT. Two patients developed a second tumor (1.4%), none of which had received GHRT. Relapse concerned 36.4% of patients without GHRT and 52.9% of patients with GHRT. The difference was not statistically significant between the two groups (p = 0.3). CONCLUSION GHRT does not lead to a statistically significant increase in risk of relapse for pediatric midline low-grade pediatric glioma in our cohort. Although these results appear reassuring, future natural history or prospective studies should be done to ascertain these findings. Nevertheless, these reassuring data regarding GHRT are in agreement with the data in the current literature.
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Affiliation(s)
- Coline Puvilland
- Pediatric Endocrinology Unit, Woman Mother Child Hospital, Lyon Civil Hospices, 69500 Bron, France
- Pediatric Unit, Hospital Fleyriat, 01012 Bourg-en-Bresse, France
- Correspondence: ; Tel.: +33-648035223
| | - Carine Villanueva
- Pediatric Endocrinology Unit, Woman Mother Child Hospital, Lyon Civil Hospices, 69500 Bron, France
| | | | - Laure Kornreich
- Department of Hematology and Oncology, Queen Fabiola Children’s University Hospital, 1020 Brussels, Belgium
| | - Iva Gueorguieva
- Pediatric Endocrine Unit, Jeanne-de-Flandre Children’s Hospital, 59000 Lille, France
| | - Mélodie-Anne Karnoub
- Department of Pediatric Neurosurgery, Lille University Hospital, 59000 Lille, France
| | - Pierre Aurélien Beuriat
- Department of Pediatric Neurosurgery, Woman Mother Child Hospital, Lyon Civil Hospices, 69500 Bron, France
- Rockfeller School of Medicine, Claude Bernard University Lyon 1, 69100 Villeurbanne, France
| | - Pierre Leblond
- Department of Pediatric Oncology, Institute of Pediatric Hematology and Oncology (IHOPe), Centre Léon Bérard, 69008 Lyon, France
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Paragliola RM, Carrozza C, Corsello SM, Salvatori R. The biochemical diagnosis of acromegaly: revising the role of measurement of IGF-I and GH after glucose load in 5 questions. Expert Rev Endocrinol Metab 2022; 17:205-224. [PMID: 35485763 DOI: 10.1080/17446651.2022.2069558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/20/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Acromegaly is a rare disorder characterized by the excessive secretion of growth hormone (GH), mostly caused by pituitary adenomas. While in full-blown cases the diagnosis is easy to establish, milder cases are more challenging. Additionally, establishing whether full cure after surgery is reached may be difficult. AREAS COVERED In this article, we will review the challenges posed by the variability in measurements of GH and its main effector insulin-like growth factor I (IGF-I) due to both biological changes, co-morbidities, and assays variability. EXPERT OPINION Interpretation of GH and IGF-I assays is important in establishing an early diagnosis of acromegaly, in avoiding misdiagnosis, and in establishing if cure is achieved by surgery. Physicians should be familiar with the variables that affect measurements of these 2 hormones, and with the performance of the assays available in their practice.
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Affiliation(s)
- Rosa Maria Paragliola
- Unit of Endocrinology, Department of Translational Medicine and Surgery - Universita' Cattolica del Sacro Cuore, Fondazione Policlinico "Gemelli", IRCCS, Rome, Italy
| | - Cinzia Carrozza
- Unit of Chemistry, Biochemistry and Clinical Molecular Biology - Università Cattolica Del Sacro Cuore, Fondazione Policlinico "Gemelli," IRCCS, Rome, Italy
| | - Salvatore M Corsello
- Unit of Endocrinology, Department of Translational Medicine and Surgery - Universita' Cattolica del Sacro Cuore, Fondazione Policlinico "Gemelli", IRCCS, Rome, Italy
- UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy
| | - Roberto Salvatori
- Division of Endocrinology Diabetes and Metabolism and Pituitary Center, Johns Hopkins University, Baltimore MD, USA
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7
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Gaddas M. Le dosage de l’Insulin-Like Growth Factor-1 : les difficultés de la détermination sérique et de l’interprétation des résultats. NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2021.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Sabbah N, Wolf P, Piedvache C, Trabado S, Verdelet T, Cornu C, Souberbielle JC, Chanson P. Reference values for IGF-I serum concentration in an adult population: use of the VARIETE cohort for two new immunoassays. Endocr Connect 2021; 10:1027-1034. [PMID: 34343107 PMCID: PMC8428081 DOI: 10.1530/ec-21-0175] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 08/03/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Measurement of IGF-I is important in the management of patients with growth hormone disorders. Here we aim to establish normative data for two new IGF-I assay kits based on a large random sample of the French general adult population. SUBJECTS AND METHODS We measured IGF-I in 911 healthy adults (18-90 years) with two immunoassays (ROCHE Elecsys® and IMMULITE-2000 calibrated against the new IS 02/2547). We compared the data with those of the six immunoassays (iSYS, LIAISON XL, IMMULITE-2000 calibrated against the first IS 87/518, IGF-I RIACT, Mediagnost ELISA, and Mediagnost RIA) that we reported previously. The pairwise concordance among the eight assays was assessed with Bland-Altman plots for both the IGF-1 raw data and the standard deviation scores (SDS), as well as with the percentage of observed agreement and the weighted Kappa coefficient for categorizing IGF-I SDS (ClinicalTrials.gov Identifier: NCT01831648). RESULTS The normative data included the range of values (2.5-97.5 percentiles) given by the two new IGF-I assays according to age group and sex. A formula for the SDS calculation is provided. As for the previous six assays, the lower limits of the reference intervals of the two new assays were similar, but the upper limits varied markedly. The pairwise concordances were only moderate (kappa 0.57). CONCLUSIONS Data obtained for these two new IGF-I immunoassays confirm that despite being obtained in the same large healthy population, the reference intervals of the eight commercial IGF-1 assay kits showed noteworthy differences. The agreement among the various methods was moderate to good.
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Affiliation(s)
- Nadia Sabbah
- Université Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Service d’Endocrinologie et des Maladies de la Reproduction, Centre de Référence des Maladies Rares de l’Hypophyse, Le Kremlin-Bicêtre, France
- Hôpital de Cayenne, Service d’Endocrinologie et des Maladies Métaboliques, Cayenne, Guyane Française
| | - Peter Wolf
- Université Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Service d’Endocrinologie et des Maladies de la Reproduction, Centre de Référence des Maladies Rares de l’Hypophyse, Le Kremlin-Bicêtre, France
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Céline Piedvache
- Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Unité de Recherche Clinique, Le Kremlin-Bicêtre, France
| | - Séverine Trabado
- Université Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Le Kremlin-Bicêtre, France
| | - Tristan Verdelet
- Université Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Service d’Endocrinologie et des Maladies de la Reproduction, Centre de Référence des Maladies Rares de l’Hypophyse, Le Kremlin-Bicêtre, France
| | - Catherine Cornu
- Centre d’Investigation Clinique, INSERM CIC1407/UMR5558, Hospices Civils de Lyon, Bron, France
| | - Jean-Claude Souberbielle
- Assistance Publique-Hôpitaux de Paris, Hôpital Necker, Service d’Explorations Fonctionnelles, Paris, France
| | - Philippe Chanson
- Université Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Service d’Endocrinologie et des Maladies de la Reproduction, Centre de Référence des Maladies Rares de l’Hypophyse, Le Kremlin-Bicêtre, France
- Correspondence should be addressed to P Chanson:
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Pratt MS, van Faassen M, Remmelts N, Bischoff R, Kema IP. An antibody-free LC-MS/MS method for the quantification of intact insulin-like growth factors 1 and 2 in human plasma. Anal Bioanal Chem 2021; 413:2035-2044. [PMID: 33569646 PMCID: PMC7943504 DOI: 10.1007/s00216-021-03185-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/23/2020] [Accepted: 01/19/2021] [Indexed: 11/26/2022]
Abstract
Insulin-like growth factors 1 and 2 (IGF-1 and IGF-2) are important biomarkers in research and diagnosis of growth disorders. Quantitative analysis is performed using various ligand-binding assays or enzymatic digestion LC-MS/MS methods, whose widespread adoption is hampered by time-consuming sample preparation procedures. We present a simple and fast antibody-free LC-MS/MS method for the quantification of intact IGF-1 and IGF-2 in human plasma. The method requires 50 μL of plasma and uses fully 15N-labelled IGF-1 as internal standard. It features trifluoroethanol (TFE)-based IGF/IGF-binding protein complex dissociation and a two-step selective protein precipitation workflow, using 5% acetic acid in 80/20 acetone/acetonitrile (precipitation 1) and ice-cold ethanol (precipitation 2). Detection of intact IGF-1 and IGF-2 is performed by means of a Waters XEVO TQ-S triple quadrupole mass spectrometer in positive electrospray ionisation (ESI+) mode. Lower limits of quantification were 5.9 ng/mL for IGF-1 and 8.4 ng/mL for IGF-2. Intra-assay imprecision was below 4.5% and inter-assay imprecision was below 5.8% for both analytes. An excellent correlation was found between nominal and measured concentrations of the WHO reference standard for IGF-1. Comparison with the IDS-iSYS IGF-1 immunoassay showed good correlation (R2 > 0.97), although a significant bias was observed with the immunoassay giving substantially higher concentrations. The LC-MS/MS method described here allows for reliable and simultaneous quantification of IGF-1 and IGF-2 in plasma, without the need for enzymatic digestion. The method can be readily implemented in clinical mass spectrometry laboratories and has the potential to be adapted for the analysis of different similarly sized peptide hormones. ![]()
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Affiliation(s)
- Mark S Pratt
- Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Martijn van Faassen
- Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Noah Remmelts
- Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Rainer Bischoff
- Department of Analytical Biochemistry, Groningen Research Institute of Pharmacy, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
| | - Ido P Kema
- Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
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Bailes J, Soloviev M. Insulin-Like Growth Factor-1 (IGF-1) and Its Monitoring in Medical Diagnostic and in Sports. Biomolecules 2021; 11:biom11020217. [PMID: 33557137 PMCID: PMC7913862 DOI: 10.3390/biom11020217] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/29/2021] [Accepted: 01/31/2021] [Indexed: 12/16/2022] Open
Abstract
Insulin-like growth factor-1 (IGF-1) is the principal mediator of growth hormone (GH), plays a crucial role in promoting cell growth and differentiation in childhood and continues to have an anabolic effect in adults. IGF-1 is part of a wide network of growth factors, receptors and binding proteins involved in mediating cellular proliferation, differentiation and apoptosis. Bioavailability of IGF-1 is affected by insulin-like growth factor binding proteins (IGFBPs) which bind IGF-1 in circulation with an affinity equal to or greater than that of the IGF-1 receptor (IGF-1R). The six IGFBPs serve as carrier proteins and bind approximately 98% of all circulating IGF-1. Other proteins known to bind IGF-1 include ten IGFBP-related proteins (IGFBP-rPs), albeit with lower affinities than the IGFBPs. IGF-1 expression levels vary in a number of clinical conditions suggesting it has the potential to provide crucial information as to the state of an individual’s health. IGF-1 is also a popular doping agent in sport and has featured in many high-profile doping cases in recent years. However, the existence of IGFBPs significantly reduces the levels of immunoreactive IGF-1 in samples, requiring multiple pre-treatment steps that reduce reproducibility and complicates interpretation of IGF-1 assay results. Here we provide an overview of the IGF network of growth factors, their receptors and the entirety of the extended family of IGFBPs, IGFBP-rPs, E peptides as well as recombinant IGF-1 and their derivatives. We also discuss issues related to the detection and quantification of bioavailable IGF-1.
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11
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Gaddas M, Périn L, Le Bouc Y. Evaluation of IGF1/IGFBP3 Molar Ratio as an Effective Tool for Assessing the Safety of Growth Hormone Therapy in Small-for-gestational-age, Growth Hormone-Deficient and Prader-Willi Children. J Clin Res Pediatr Endocrinol 2019; 11:253-261. [PMID: 30759961 PMCID: PMC6745465 DOI: 10.4274/jcrpe.galenos.2019.2018.0277] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE IGF1 concentration is the most widely used parameter for the monitoring and therapeutic adaptation of recombinant human growth hormone (rGH) treatment. However, more than half the variation of the therapeutic response is accounted for by variability in the serum concentrations of IGF1 and IGFBP3. We therefore compared the use of IGF1/IGFBP3 molar ratio with that of IGF1 concentration alone. METHODS We selected 92 children on rGH for this study and assigned them to three groups on the basis of growth deficiency etiology: small for gestational age (SGA), GH deficiency (GHD) and Prader-Willi syndrome (PWS). Plasma IGF1 and IGFBP3 concentrations and their molar ratio were determined. RESULTS Before rGH treatment, mean IGF1/IGFBP3 molar ratio in the SGA, GHD and PWS groups was 0.14±0.04, 0.07±0.01 and 0.12±0.02, respectively. After the initiation of rGH treatment, these averages were 0.19±0.07, 0.20±0.08 and 0.19±0.09, within the normal range for most children, even at puberty and despite some significant increases in serum IGF1 levels. CONCLUSION We consider IGF1/IGFBP3 molar ratio to be a useful additional parameter for assessing therapeutic safety in patients on rGH, and for maintaning the values within the normal range for age and pubertal stage.
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Affiliation(s)
- Meriem Gaddas
- University of Sousse, Faculty of Medicine ‘Ibn el Jazzar’, Department of Physiology and Functional Explorations, Sousse, Tunisia,* Address for Correspondence: University of Sousse, Faculty of Medicine ‘Ibn el Jazzar’, Department of Physiology and Functional Explorations, Sousse, Tunisia Phone: +21698569921 E-mail:
| | - Laurence Périn
- Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Department of Pediatric Endocrinology, Paris, France
| | - Yves Le Bouc
- Sorbonne Université, INSERM, Centre de Recherche St-Antoine UMR S938, Assistance Publique-Hôpitaux de Paris, Trousseau Hospital, Department of Pediatric Endocrinology, Paris, France
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Varewijck AJ, van der Lely AJ, Neggers SJCMM, Hofland LJ, Janssen JAMJL. Disagreement in normative IGF-I levels may lead to different clinical interpretations and GH dose adjustments in GH deficiency. Clin Endocrinol (Oxf) 2018; 88:409-414. [PMID: 28977695 DOI: 10.1111/cen.13491] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 09/21/2017] [Accepted: 09/26/2017] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND BACKGROUND Normative data for the iSYS IGF-I assay have been published both in the VARIETE cohort and by Bidlingmaier et al. OBJECTIVE To investigate whether normative data of the VARIETE cohort lead to differences in Z-scores for total IGF-I and clinical interpretation compared to normative data of Bidlingmaier et al. DESIGN We used total IGF-I values previously measured by the IDS-iSYS assay in 102 GH-deficient subjects before starting GH treatment and after 12 months of GH treatment. Z-scores were calculated for all samples by using the normative data of the VARIETE cohort and by the normative data reported by Bidlingmaier et al. RESULT Before GH treatment, Z-scores calculated by using the normative data of the VARIETE cohort were significantly lower than those calculated by the normative data of Bidlingmaier et al: -2.40 (-4.52 to +1.31) (mean [range]) vs. -1.41 (-3.14 to +1.76); P < .001). After 12 months of GH treatment, again the Z-scores based on the normative data of the VARIETE cohort were significantly lower than those based on the normative data of Bidlingmaier et al: -0.65 (-4.32 to +2.79) vs 0.21 (-3.00 to +3.28); P < .001). CONCLUSION IGF-I Z-scores in 102 GH-deficient subjects differed significantly when normative data from two different sources were used. In daily clinical practice, this would most likely have led to different clinical interpretations and GH dose adjustments.
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Affiliation(s)
- A J Varewijck
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, Rotterdam, The Netherlands
| | - A J van der Lely
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, Rotterdam, The Netherlands
| | - S J C M M Neggers
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, Rotterdam, The Netherlands
| | - L J Hofland
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, Rotterdam, The Netherlands
| | - J A M J L Janssen
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, Rotterdam, The Netherlands
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Bonert V, Carmichael J, Wu Z, Mirocha J, Perez DA, Clarke NJ, Reitz RE, McPhaul MJ, Mamelak A. Discordance between mass spectrometry and immunometric IGF-1 assay in pituitary disease: a prospective study. Pituitary 2018; 21:65-75. [PMID: 29218459 DOI: 10.1007/s11102-017-0849-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE Measuring IGF-1, a biomarker for GH activity, is critical to evaluating disordered hypothalamic-pituitary GH axis. Inconsistent IGF-1 measurements among different immunoassays are well documented. We switched from Immulite 2000 immunoassay to narrow-mass-extraction, high-resolution liquid chromatography mass-spectrometry (LC-MS) compliant with recent consensus recommendations on assay standardization. Comparability of these two assays in patients with pituitary disease in a clinical practice setting is not known. We sought to compare IGF-1 levels on Immulite 2000 and LC-MS in samples from naïve and treated patients with secretory and non-secretory pituitary masses. METHODS We prospectively collected serum samples from 101 patients treated at the Cedars-Sinai Pituitary Center between February 2012 and March 2014. We intentionally recruited more patients with acromegaly or GH deficiency to ensure a clinically representative cohort. Samples were classified as in or out of the respective reference ranges. Bland-Altman analysis was used to assess agreement between assays. RESULTS Twenty-four percent of samples were classified differently as below, in, or above range. Agreement between the assays was poor overall, with a significant bias for immunoassay reporting higher values than LC-MS. This pattern was also observed in patients with acromegaly and those with ≥ 2 pituitary hormone deficiencies. CONCLUSIONS IGF-1 results may differ after switching from an older immunoassay to a consensus-compliant assay such as LC-MS. Clinicians should consider the potential impact of assay switching before altering treatment due to discrepant results, particularly in patients monitored over time, such as those with acromegaly and GH deficiency.
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Affiliation(s)
- Vivien Bonert
- Pituitary Center, Department of Medicine, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd., Advanced Health Sciences Pavilion, Sixth Floor, A6600, Los Angeles, CA, 90048, USA.
| | - John Carmichael
- Pituitary Center, Department of Medicine, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd., Advanced Health Sciences Pavilion, Sixth Floor, A6600, Los Angeles, CA, 90048, USA
| | - Zengru Wu
- Quest Diagnostics, Inc., San Juan Capistrano, CA, 92675, USA
| | - James Mirocha
- Pituitary Center, Department of Medicine, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd., Advanced Health Sciences Pavilion, Sixth Floor, A6600, Los Angeles, CA, 90048, USA
| | - Daniel A Perez
- Pituitary Center, Department of Medicine, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd., Advanced Health Sciences Pavilion, Sixth Floor, A6600, Los Angeles, CA, 90048, USA
| | - Nigel J Clarke
- Quest Diagnostics, Inc., San Juan Capistrano, CA, 92675, USA
| | - Richard E Reitz
- Quest Diagnostics, Inc., San Juan Capistrano, CA, 92675, USA
| | | | - Adam Mamelak
- Pituitary Center, Department of Medicine, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd., Advanced Health Sciences Pavilion, Sixth Floor, A6600, Los Angeles, CA, 90048, USA
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Abstract
Measurements of human growth hormone (GH) and insulin-like growth-factor I (IGF-I) are cornerstones in the diagnosis of acromegaly. Both hormones are also used as biochemical markers in the evaluation of disease activity during treatment. Management of acromegaly is particularly challenging in cases where discordant information is obtained from measurement of GH concentrations following oral glucose load and from measurement of IGF-I. While in some patients biological factors can explain the discrepancy, in many cases issues with the analytical methods seem to be responsible. Assays used by endocrine laboratories to determine concentrations of GH and IGF-I underwent significant changes during the last decades. While generally leading to more sensitive and reproducible methods, these changes also had considerable impact on absolute concentrations measured. This must be reflected by updated decision limits, cut-offs and reference intervals. Since different commercially available assays do not agree very well, method specific interpretation of GH and IGF-I concentrations is required. This complexity in the interpretation of hormone concentrations is not always appropriately reflected in laboratory reports, but also not in clinical guidelines reporting decision limits not related to a specific analytical method. The present review provides an overview about methodological and biological variables affecting the biochemical assessment of acromegaly in diagnosis and follow up.
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Affiliation(s)
- Katharina Schilbach
- Clinical Endocrinology and Endocrine Laboratory, Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität (LMU), Ziemssenstr. 1, 80336, Munich, Germany
| | - Christian J Strasburger
- Department of Endocrinology and Metabolic Diseases, Campus Charité Mitte, Charité Universitätsmedizin, Charitéplatz 1, 10117, Berlin, Germany
| | - Martin Bidlingmaier
- Endocrine Laboratory, Endocrine Research Unit, Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität (LMU), Ziemssenstr. 1, 80336, Munich, Germany.
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15
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Chanson P, Arnoux A, Mavromati M, Brailly-Tabard S, Massart C, Young J, Piketty ML, Souberbielle JC. Reference Values for IGF-I Serum Concentrations: Comparison of Six Immunoassays. J Clin Endocrinol Metab 2016; 101:3450-8. [PMID: 27167056 PMCID: PMC5054194 DOI: 10.1210/jc.2016-1257] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
CONTEXT Measurement of IGF-I is essential for diagnosis and management of patients with disorders affecting the somatotropic axis. However, even when IGF-I kit manufacturers follow recent consensus guidelines, different kits can give very different results for a given sample. OBJECTIVES We sought to establish normative data for six IGF-I assay kits based on a large random sample of the French general adult population. SUBJECTS AND METHODS In a cross-sectional multicenter cohort study, we measured IGF-I in 911 healthy adults (18-90 years) with six immunoassays (iSYS, LIAISON XL, IMMULITE, IGFI RIACT, Mediagnost ELISA, and Mediagnost RIA). Pairwise concordance between assays was assessed with Bland-Altman plots for both IGF-1 raw data and standard deviation scores (SDS), as well as with the percentage of observed agreement and the weighted Kappa coefficient for categorized IGF-I SDS. RESULTS Normative data included the range of values (2.5-97.5 percentiles) given by the six IGF-I assays according to age group and sex. A formula for SDS calculation is provided. Although the lower limits of the reference intervals of the six assays were similar, the upper limits varied markedly. Pairwise concordances were moderate to good (0.38-0.70). CONCLUSION Despite being obtained in the same healthy population, the reference intervals of the six commercial IGF-1 assay kits showed noteworthy differences. Agreement between methods was moderate to good.
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Affiliation(s)
- Philippe Chanson
- Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance (P.C., M.M., J.Y.), Unité de Recherche Clinique (A.A.), and Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie (S.B.T.), Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin-Bicêtre, F94275, France; Inserm 1185 (P.C., S.B.T., J.Y.), Fac Med Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, F-94276, France; and Laboratoire d'Hormonologie (C.M.), Centre Hospitalier Universitaire de Rennes, Centre d'Investigation Clinique Plurithématique, Inserm 1414, Hôpital Pontchaillou, Rennes, F29000, France; Service des Explorations Fonctionnelles (M-L.P., J.-C.S.), Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, F75015, France
| | - Armelle Arnoux
- Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance (P.C., M.M., J.Y.), Unité de Recherche Clinique (A.A.), and Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie (S.B.T.), Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin-Bicêtre, F94275, France; Inserm 1185 (P.C., S.B.T., J.Y.), Fac Med Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, F-94276, France; and Laboratoire d'Hormonologie (C.M.), Centre Hospitalier Universitaire de Rennes, Centre d'Investigation Clinique Plurithématique, Inserm 1414, Hôpital Pontchaillou, Rennes, F29000, France; Service des Explorations Fonctionnelles (M-L.P., J.-C.S.), Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, F75015, France
| | - Maria Mavromati
- Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance (P.C., M.M., J.Y.), Unité de Recherche Clinique (A.A.), and Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie (S.B.T.), Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin-Bicêtre, F94275, France; Inserm 1185 (P.C., S.B.T., J.Y.), Fac Med Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, F-94276, France; and Laboratoire d'Hormonologie (C.M.), Centre Hospitalier Universitaire de Rennes, Centre d'Investigation Clinique Plurithématique, Inserm 1414, Hôpital Pontchaillou, Rennes, F29000, France; Service des Explorations Fonctionnelles (M-L.P., J.-C.S.), Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, F75015, France
| | - Sylvie Brailly-Tabard
- Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance (P.C., M.M., J.Y.), Unité de Recherche Clinique (A.A.), and Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie (S.B.T.), Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin-Bicêtre, F94275, France; Inserm 1185 (P.C., S.B.T., J.Y.), Fac Med Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, F-94276, France; and Laboratoire d'Hormonologie (C.M.), Centre Hospitalier Universitaire de Rennes, Centre d'Investigation Clinique Plurithématique, Inserm 1414, Hôpital Pontchaillou, Rennes, F29000, France; Service des Explorations Fonctionnelles (M-L.P., J.-C.S.), Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, F75015, France
| | - Catherine Massart
- Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance (P.C., M.M., J.Y.), Unité de Recherche Clinique (A.A.), and Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie (S.B.T.), Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin-Bicêtre, F94275, France; Inserm 1185 (P.C., S.B.T., J.Y.), Fac Med Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, F-94276, France; and Laboratoire d'Hormonologie (C.M.), Centre Hospitalier Universitaire de Rennes, Centre d'Investigation Clinique Plurithématique, Inserm 1414, Hôpital Pontchaillou, Rennes, F29000, France; Service des Explorations Fonctionnelles (M-L.P., J.-C.S.), Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, F75015, France
| | - Jacques Young
- Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance (P.C., M.M., J.Y.), Unité de Recherche Clinique (A.A.), and Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie (S.B.T.), Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin-Bicêtre, F94275, France; Inserm 1185 (P.C., S.B.T., J.Y.), Fac Med Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, F-94276, France; and Laboratoire d'Hormonologie (C.M.), Centre Hospitalier Universitaire de Rennes, Centre d'Investigation Clinique Plurithématique, Inserm 1414, Hôpital Pontchaillou, Rennes, F29000, France; Service des Explorations Fonctionnelles (M-L.P., J.-C.S.), Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, F75015, France
| | - Marie-Liesse Piketty
- Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance (P.C., M.M., J.Y.), Unité de Recherche Clinique (A.A.), and Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie (S.B.T.), Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin-Bicêtre, F94275, France; Inserm 1185 (P.C., S.B.T., J.Y.), Fac Med Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, F-94276, France; and Laboratoire d'Hormonologie (C.M.), Centre Hospitalier Universitaire de Rennes, Centre d'Investigation Clinique Plurithématique, Inserm 1414, Hôpital Pontchaillou, Rennes, F29000, France; Service des Explorations Fonctionnelles (M-L.P., J.-C.S.), Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, F75015, France
| | - Jean-Claude Souberbielle
- Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance (P.C., M.M., J.Y.), Unité de Recherche Clinique (A.A.), and Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie (S.B.T.), Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin-Bicêtre, F94275, France; Inserm 1185 (P.C., S.B.T., J.Y.), Fac Med Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, F-94276, France; and Laboratoire d'Hormonologie (C.M.), Centre Hospitalier Universitaire de Rennes, Centre d'Investigation Clinique Plurithématique, Inserm 1414, Hôpital Pontchaillou, Rennes, F29000, France; Service des Explorations Fonctionnelles (M-L.P., J.-C.S.), Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, F75015, France
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Sheikholeslami-Vatani D, Ahmadi S, Salavati R. Comparison of the Effects of Resistance Exercise Orders on Number of Repetitions, Serum IGF-1, Testosterone and Cortisol Levels in Normal-Weight and Obese Men. Asian J Sports Med 2016; 7:e30503. [PMID: 27217934 PMCID: PMC4870831 DOI: 10.5812/asjsm.30503] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 07/13/2015] [Accepted: 08/16/2015] [Indexed: 12/04/2022] Open
Abstract
Background: Exercise order affects repetition performance and acute hormonal responses to resistance training (RT) programs. Objectives: The purpose of this study was to compare the acute effects of two different resistance exercise orders (REO) on number of repetitions and serum Insulin-like Growth Factor-1 (IGF-1), testosterone and cortisol levels in normal-weight and obese men. Materials and Methods: 25 untrained college-aged men were assigned to either obese (n = 11) or normal-weight (n = 15) groups. Subjects performed two REO protocols in 2 exercise groups. In the first group subjects began with large-muscle group and progressed to small-muscle group (Protocol A), while in the other group subjects performed the same exercise but in reverse sequence (Protocol B). Each activity was performed in 3 consecutive sets of 10 repetitions maximum to near fatigue. Results: REOs did not affect number of repetitions in none of the groups. The average rating of perceived exertion was higher for protocol B in both groups. IGF-1 and testosterone increased immediately post exercise for both protocols and in both groups, however immediately post exercise increase in IGF-1 and testosterone were lower in obese group. Cortisol response to REO was weaker in obese group. Conclusions: Performing large muscle group exercises first in RE training and progressing to small muscle group produced greater anabolic hormonal response relative to reverse sequence in normal-weight young adult men. Anabolic hormonal response to REOs was blunted in the obese group.
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Affiliation(s)
| | - Slahadin Ahmadi
- Department of Physiology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, IR Iran
- Cellular and Molecular Research Center, Kurdistan University of Medical Sciences, Sanandaj, IR Iran
- Corresponding author: Slahadin Ahmadi, Department of Physiology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, IR Iran. Tel: +87-31827399, Fax: +87-33664654, E-mail:
| | - Rashad Salavati
- Department of Physical Education and Sport Sciences, University of Kurdistan, Sanandaj, IR Iran
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Andries A, Frystyk J, Flyvbjerg A, Støving RK. Changes in IGF-I, urinary free cortisol and adipokines during dronabinol therapy in anorexia nervosa: Results from a randomised, controlled trial. Growth Horm IGF Res 2015; 25:247-252. [PMID: 26248813 DOI: 10.1016/j.ghir.2015.07.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 07/07/2015] [Accepted: 07/14/2015] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Anorexia nervosa (AN) is characterised by complex neuroendocrine disturbances due to severe underweight, physical hyperactivity and purging behaviour. Cannabinoid agonists are used to palliate cachexia of various causes, but their interactions with the hormonal systems that are involved in energy metabolism have not been previously described in humans. Therefore we found it of interest to assess interactions between the synthetic cannabinoid agonist dronabinol and insulin-like growth factor I (IGF-I), urinary free cortisol (UFC) and adipokines in patients with chronic AN. DESIGN This was a prospective, double-blind randomised crossover study, conducted at a specialised care centre for eating disorders. The results are based on twenty-four adult women with chronic AN, who completed the study. The participants received dronabinol (oral capsules, 5mg daily) and matching placebo over four weeks, separated by a four-week washout period. Bioactive IGF was determined by a cell-based bioassay, whereas total IGF-I, IGFBP-2 and -3 and the two adipokines leptin and adiponectines were measured by immunoassays. The UFC excretion was determined by mass spectrometry. RESULTS As previously reported, dronabinol treatment caused a small, yet significant increase in BMI as compared to placebo (+0.23 kg/m(2); P = 0.04). This modest weight gain predicted a corresponding increase in bioactive IGF-I, while the amount of daily energy expenditure due to physical activity had a comparable but opposite effect. Nevertheless, neither IGF-I, bioactive IGF nor the IGFBPs levels changed significantly during dronabinol intervention as compared to placebo. Adiponectin also remained unaffected by the weight gain, whereas plasma leptin showed a transient increase at three weeks (P < 0.05). UFC levels were decreased during dronabinol intervention. CONCLUSION Our results showed that low-dosage therapy with the synthetic cannabinoid agonist dronabinol affected neither the concentration nor the activity of the circulating IGF-system in women with severe and chronic AN. However, our results suggest that such treatment may alleviate the increased hypothalamic-pituitary-adrenal axis activity seen in these patients.
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Affiliation(s)
- Alin Andries
- Center for Eating Disorders, Department of Endocrinology, Odense University Hospital, DK-5000 Odense C, Denmark.
| | - Jan Frystyk
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital and Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, DK-8000 Aarhus C, Denmark
| | - Allan Flyvbjerg
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital and Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, DK-8000 Aarhus C, Denmark
| | - René Klinkby Støving
- Center for Eating Disorders, Department of Endocrinology, Odense University Hospital, DK-5000 Odense C, Denmark
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18
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Guitelman M, Smithuis F, Garcia Basavilbaso N, Aranda C, Fabre B, Oneto A. Reference ranges for an automated chemiluminescent assay for serum insulin-like growth factor I (IGF-I) in a large population of healthy adults from Buenos Aires. J Endocrinol Invest 2015; 38:951-6. [PMID: 25740070 DOI: 10.1007/s40618-015-0265-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 02/19/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE Insulin-like growth factor I (IGF-I) represents an essential tool in the diagnostic work-up and in the monitoring of treatment efficacy for somatotrophic axis disorders both in children and adults. A large number of factors including, but not limited to, age, sex and weight as well as analytical variables influence IGF-I serum levels; therefore, reliable normative data are essential for a correct interpretation of results. The aim of the present study was to establish reference range values for serum IGF-I, in a large population of healthy adults from Buenos Aires city. METHODS The study included serum samples from 1044 healthy subjects aged 21-87 years (423 females and 621 males) divided into groups by sex at 5-year intervals from 21 to >75 years. Serum IGF-I concentrations were determined by a fully automated two-site, solid-phase, enzyme-labeled chemiluminescent immunometric assay (Immulite 2000, Siemens Healthcare Diagnostics). IGF-BP interferences are circumvented by blocking IGF-BP binding sites with excess IGF-II in the on-board predilution step. RESULTS Results show the age dependence of circulating IGF-I levels, with a smooth and steady decrease in levels with age. No sex differences were found in subjects >26 years; however, in the group aged 21-25 years, IGF-I levels were significantly higher in females. In conclusion, this study provides age- and gender-adjusted normal reference ranges for IGF-I levels obtained with an automated immunometric chemiluminescent assay Immulite 2000 in healthy adult subjects.
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Affiliation(s)
- M Guitelman
- División Endocrinología, Hospital Carlos G Durand, Buenos Aires, Argentina
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19
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Raverot G, Assié G, Cotton F, Cogne M, Boulin A, Dherbomez M, Bonneville JF, Massart C. Biological and radiological exploration and management of non-functioning pituitary adenoma. ANNALES D'ENDOCRINOLOGIE 2015; 76:201-9. [DOI: 10.1016/j.ando.2015.04.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 04/29/2015] [Indexed: 11/29/2022]
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Junnila RK, Strasburger CJ, Bidlingmaier M. Pitfalls of insulin-like growth factor-i and growth hormone assays. Endocrinol Metab Clin North Am 2015; 44:27-34. [PMID: 25732639 DOI: 10.1016/j.ecl.2014.10.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Accurate measurement of growth hormone (GH) and insulin-like growth factor-I (IGF-I) are the key to correct diagnosis of acromegaly and GH deficiency. Unfortunately, there is much variation involved when these hormones are measured at different sites and using different assay methods. There is an ongoing global effort to standardize the measurement process to obtain more comparable results in the future. This review discusses common pitfalls in the measurement of GH and IGF-I and guides laboratories in their analyses of these hormones.
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Affiliation(s)
- Riia K Junnila
- Endocrine Research Unit, Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität (LMU), Ziemssenstr. 1, Munich 80336, Germany
| | - Christian J Strasburger
- Department of Endocrinology and Metabolic Diseases, Campus Charité Mitte, Charité Universitaetsmedizin, Charitéplatz 1, Berlin 10117, Germany
| | - Martin Bidlingmaier
- Endocrine Research Unit, Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität (LMU), Ziemssenstr. 1, Munich 80336, Germany.
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Blankenstein O, Pedersen BT, Schlumpf M, Andreasen AH, Júlíusson PB. Management and interpretation of heterogeneous observational data: using insulin-like growth factor-I data from the NordiNet® International Outcome Study. Growth Horm IGF Res 2015; 25:41-46. [PMID: 25542446 DOI: 10.1016/j.ghir.2014.12.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 11/24/2014] [Accepted: 12/02/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The NordiNet® International Outcome Study (IOS), a large-scale, non-interventional, multi-centre, real-world study of Norditropin® treatment, registers insulin-like growth factor-I (IGF-I) values, as measured by different assays. This paper considers the potential biases introduced by using a single IGF-I reference data set in analysing NordiNet® IOS data. DESIGN To evaluate possible biases from different IGF-I assays used across NordiNet® IOS, a mixed-effect linear model was fitted to IGF-I data (analyses on log-transformed data). Pre-growth hormone treatment (pre-GHT) IGF-I values were assumed to depend on diagnosis, sex and age. During GHT, a treatment-effect dependent on these factors was added. Differences between assays were assumed multiplicative on the original scale. Individual measurements were scaled to a common level (Nichols Advantage) giving adjusted IGF-I standard deviation score (SDS) values. RESULTS In total, 49 495 IGF-I measurements were available from 9481 paediatric patients. Mixed-effect linear modelling showed a systematic difference between IGF-I levels measured by different assays. Differences were minimised when assessing change in IGF-I SDS from the start of GHT to 1-year follow-up. This applied to values adjusted for actual-assay used and for unadjusted delta IGF-I SDS values. Largest differences between unadjusted change in IGF-I SDS values were: for growth hormone deficiency 0.1 (girls) and 0.3 (boys); for small-for-gestational age 0.1; and for Turner syndrome 0.2. Similar magnitude differences were seen for data with unknown assay. CONCLUSIONS Analysis and modelling suggest the current approach to IGF-I data collection and analyses in the NordiNet® IOS is sound: in a large cohort without assay-used information, potential bias is minimised by analysing changes in IGF-I SDS.
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Affiliation(s)
- Oliver Blankenstein
- Institute for Experimental Paediatric Endocrinology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | | | - Michael Schlumpf
- Global Medical Affairs Biopharm, Novo Nordisk Health Care AG, Zurich, Switzerland.
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Ramadhin C, Pillay B, Olaniran AO. Cell-based assays for IGF-I bioactivity measurement: overview, limitations and current trends. Growth Factors 2014; 32:130-8. [PMID: 25060037 DOI: 10.3109/08977194.2014.939806] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Insulin-like growth factor-I (IGF-I) is an important growth promoting protein that is involved in numerous cellular responses and multiple biological systems. Although the molecular structure, function and recombinant production of IGF-I in various hosts have been the subject of much researches over the recent past, methods to determine the bioactivity of this protein have not been fully explored. Several assays have traditionally been used to measure IGF-I bioactivity, but have not become a routine laboratory practice due to the high cost involved and technical problems. Thus, there is still a need for a rapid, technically simple and accurate assay to determine IGF-I bioactivity. This review highlights the various cell-based assays currently commercially available for measuring the bioactivity of IGF-I along with their limitations. This is aimed at presenting the modern-day IGF researcher with a holistic overview of the current trends and future prospects regarding IGF-I bioactivity determinations.
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Affiliation(s)
- Charlotte Ramadhin
- Discipline of Microbiology, School of Life Sciences, College of Agriculture, Engineering and Science, University of KwaZulu-Natal , Durban , Republic of South Africa
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Bidlingmaier M, Friedrich N, Emeny RT, Spranger J, Wolthers OD, Roswall J, Körner A, Obermayer-Pietsch B, Hübener C, Dahlgren J, Frystyk J, Pfeiffer AFH, Doering A, Bielohuby M, Wallaschofski H, Arafat AM. Reference intervals for insulin-like growth factor-1 (igf-i) from birth to senescence: results from a multicenter study using a new automated chemiluminescence IGF-I immunoassay conforming to recent international recommendations. J Clin Endocrinol Metab 2014; 99:1712-21. [PMID: 24606072 DOI: 10.1210/jc.2013-3059] [Citation(s) in RCA: 244] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
CONTEXT Measurement of IGF-I is a cornerstone in diagnosis and monitoring of GH-related diseases, but considerable discrepancies exist between analytical methods. A recent consensus conference defined criteria for validation of IGF-I assays and for establishment of normative data. OBJECTIVES Our objectives were development and validation of a novel automated IGF-I immunoassay (iSYS; Immunodiagnostic Systems) according to international guidelines and establishment of method-specific age- and sex-adjusted reference intervals and analysis of their robustness. SETTING AND PARTICIPANTS We conducted a multicenter study with samples from 12 cohorts from the United States, Canada, and Europe including 15 014 subjects (6697 males and 8317 females, 0-94 years of age). MAIN OUTCOME MEASURES We measured concentrations of IGF-I as determined by the IDS iSYS IGF-I assay. RESULTS A new IGF-I assay calibrated against the recommended standard (02/254) and insensitive to the 6 high-affinity IGF binding proteins was developed and rigorously validated. Age- and sex-adjusted reference intervals derived from a uniquely large cohort reflect the age-related pattern of IGF-I secretion: a decline immediately after birth followed by an increase until a pubertal peak (at 15 years of age). Later in life, values decrease continuously. The impact of gender is small, although across the lifespan, women have lower mean IGF-I concentrations. Geographical region, sampling setting (community or hospital based), and rigor of exclusion criteria in our large cohort did not affect the reference intervals. CONCLUSIONS Using large cohorts of well-characterized subjects from different centers allowed construction of robust reference ranges for a new automated IGF-I assay. The strict adherence to recent consensus criteria for IGF-I assays might facilitate clinical application of the results.
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Affiliation(s)
- Martin Bidlingmaier
- Endocrine Research Laboratories (M.Bid., M.Bie.), Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, 80336 Munich, Germany; Metabolic Center (N.F., H.W.), Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, 17475 Greifswald, Germany; Helmholtz Zentrum München-German Research Center for Environmental Health (GmbH) (R.T.E., A.D.), Institute of Epidemiology II, 85764 Neuherberg, Germany; Department of Endocrinology, Diabetes, and Nutrition (J.S., A.F.H.P., A.M.A.), Charité-University Medicine Berlin, 10117 Berlin, Germany; Experimental and Clinical Research Center (J.S.), Charité-University Medicine Berlin and Max-Delbrück Centre Berlin-Buch, 13125 Berlin, Germany; Center for Cardiovascular Research (J.S., A.M.A.), Charité-University Medicine Berlin, 10115 Berlin, Germany; Children's Clinic Randers (O.D.W.), DK-8900 Randers, Denmark; Göteborg Pediatric Growth Research Center (J.R.), The Sahlgrenska Academy at University of Gothenburg, 41685 Gothenburg, Sweden; Center for Pediatric Research (A.K.), Hospital for Children and Adolescents, Department of Women's and Child Health, University of Leipzig, 04103 Leipzig, Germany; Klinische Abteilung und Labor für Endokrinologie und Stoffwechsel (B.O.-P.), Universitätsklinik für Innere Medizin, Medizinische Universität Graz, 8036 Graz, Austria; Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe-Grosshadern (C.H.), Klinikum der Universität München, 81377 Munich, Germany; Medical Research Laboratory (J.F.), Department of Clinical Medicine, Faculty of Health, Aarhus University, DK-8000 Aarhus, Denmark; Department of Endocrinology and Internal Medicine (J.F.), Aarhus University Hospital, DK-8000 Aarhus, Denmark; and Department of Clinical Nutrition (A.F.H.P., A.M.A.), German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany
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Anwar GM, Kandeel WA, Mandour IA, Kamal AN. Study of primary IGF-1 deficiency in Egyptian children with idiopathic short stature. Horm Res Paediatr 2014; 79:277-82. [PMID: 23635650 DOI: 10.1159/000350824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Accepted: 03/13/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Primary insulin-like growth factor-1 (IGF-1) deficiency (IGFD) is defined by low levels of IGF-1 without growth hormone (GH) deficiency and absence of secondary causes. The aim of this study was to evaluate IGF-1 in Egyptian children with idiopathic short stature (ISS) and describe patients with IGFD. METHODS This cross-sectional study included 50 children with ISS following up at the Diabetes Endocrine and Metabolism Pediatric Unit at Cairo University Pediatric Hospital. Children were included based on the following criteria: (1) short stature with current height standard deviation score (SDS) ≤-2.5; (2) age between 2 and 9 years in boys and 2 and 8 years in girls, and (3) prepubertal status. Exclusion criteria were: (1) identified cause of short stature and (2) pubertal children. IGF-1-deficient children were defined as children without GH deficiency and with IGF-1 levels below the 2.5th percentile. RESULTS Among 50 children with ISS, 14 (28%) patients had low IGF-1 levels, consistent with the diagnosis of primary IGFD. When compared with non-IGFD children, IGFD children had lower birth weight SDS (-1.8 vs. -0.7 SDS, p < 0.0001) and lower height SDS (-4.2 vs. -3.1 SDS, p < 0.05) and more delayed bone age (2.6 vs. 1.6 years, p = 0.001). CONCLUSION Primary IGF-1 deficiency is found in 28% of children with ISS.
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Affiliation(s)
- Ghada M Anwar
- Department of Pediatrics, Cairo University, Cairo, Egypt.
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Abstract
The worldwide clinical and scientific interest in peptides belonging to the insulin-like growth factor (IGF) system has brought along a call for standardization of assays used to quantify the different IGF related proteins. This relates in particular to the measurement of IGF-I, which has stood the test of time as an important biochemical tool in the diagnosis and treatment of growth hormone (GH) related disorders. The first international consensus statement on the measurement of IGF-I in 2011 represents an important milestone and will undoubtedly improve commutability of reference ranges for IGF-I and clinically applicable cut-off values. By contrast, there is no consensus addressing the measurements of the other IGF-related peptides. Nevertheless, measurement of these peptides may be of interest, either as additional tools in GH disorders or as prognostic biomarkers of various diseases. Therefore, standardization of assays for the other IGF-related peptides is highly relevant. This chapter discusses the recent consensus on IGF-I measurements and how this approach may be applied to measurement of the other IGF-related peptides. In addition, assay pitfalls, pre- and post-analytical challenges, alternative methods for IGF-I measurements and potential assays of tomorrow will be discussed.
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Affiliation(s)
- Rikke Hjortebjerg
- Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, DK-8000 Aarhus C, Denmark
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Targeted selected reaction monitoring mass spectrometric immunoassay for insulin-like growth factor 1. PLoS One 2013; 8:e81125. [PMID: 24278387 PMCID: PMC3836743 DOI: 10.1371/journal.pone.0081125] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 10/09/2013] [Indexed: 11/30/2022] Open
Abstract
Insulin-like growth factor 1 (IGF1) is an important biomarker of human growth disorders that is routinely analyzed in clinical laboratories. Mass spectrometry-based workflows offer a viable alternative to standard IGF1 immunoassays, which utilize various pre-analytical preparation strategies. In this work we developed an assay that incorporates a novel sample preparation method for dissociating IGF1 from its binding proteins. The workflow also includes an immunoaffinity step using antibody-derivatized pipette tips, followed by elution, trypsin digestion, and LC-MS/MS separation and detection of the signature peptides in a selected reaction monitoring (SRM) mode. The resulting quantitative mass spectrometric immunoassay (MSIA) exhibited good linearity in the range of 1 to 1,500 ng/mL IGF1, intra- and inter-assay precision with CVs of less than 10%, and lowest limits of detection of 1 ng/mL. The linearity and recovery characteristics of the assay were also established, and the new method compared to a commercially available immunoassay using a large cohort of human serum samples. The IGF1 SRM MSIA is well suited for use in clinical laboratories.
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Guha N, Cowan DA, Sönksen PH, Holt RIG. Insulin-like growth factor-I (IGF-I) misuse in athletes and potential methods for detection. Anal Bioanal Chem 2013; 405:9669-83. [DOI: 10.1007/s00216-013-7229-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 07/02/2013] [Accepted: 07/08/2013] [Indexed: 11/30/2022]
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Abstract
The growth hormone/insulin-like growth factor (GH/IGF) axis is widely investigated in disorders of growth, development, and anterior pituitary function. Methods are described for three hormones in this axis (growth hormone, IGF-I, and IGF binding protein-3). Enzyme-linked immunosorbent assays (ELISAs) are described as they combine the specificity of antibody-antigen interactions with the sensitivity of simple enzyme assays. Many commercial immunoassays are available for the measurement of GH and IGF-I, and the main problems encountered in the measurement of these clinically important hormones are discussed.
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Affiliation(s)
- Nishan Guha
- Department of Clinical Biochemistry, John Radcliffe Hospital, Oxford, UK
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Frystyk J. Quantification of the GH/IGF-axis components: lessons from human studies. Domest Anim Endocrinol 2012; 43:186-97. [PMID: 22153974 DOI: 10.1016/j.domaniend.2011.11.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2011] [Revised: 11/08/2011] [Accepted: 11/09/2011] [Indexed: 11/30/2022]
Abstract
Originally, the circulating bioactivity of IGF-I was estimated by bioassays measuring the ability of serum to stimulate uptake of labeled sulfate or thymidine in cultures of costal cartilage or by the ability of serum to stimulate the uptake of glucose in fat tissue cultures. However, because of their laborious and unspecific nature, the original bioassays were quickly abandoned with the development of the first RIA for IGF-I in 1977. Consequently, for the past three decades the endogenous IGF-I bioactivity has been almost exclusively estimated by the use of immunoassays. Beyond any doubt, the immunoassays have provided an extensive insight into IGF-I physiology and pathophysiology. However, immunoassays ignore the presence of the IGFBPs, which are important regulators of IGF-I action in vivo. In addition, immunoassays do not consider the presence of IGF-II, which also interacts with the IGF-I receptor (IGF-IR). This aroused our interest to reintroduce the bioassay; therefore, we established a cell-based kinase receptor activation (KIRA) assay based on cells transfected with the human IGF-IR. The output signal of the KIRA assay is IGF-IR phosphorylation, and, as such, it is highly specific. Further, because detection of phosphorylated IGF-IRs is based on modern immunoassay techniques, the overall performance of the assay is close to that of a traditional IGF-I immunoassay. The first part of this review comprises a short description of the bioassay, and a more in-depth presentation of the data that have been obtained so far. It will be demonstrated that the bioassay is indeed able to yield novel information on the IGF system, most likely because it is able to integrate the different components of the IGF system into one signal: IGF-IR activation. As IGF-I, circulating GH is bound to larger proteins, the far most important GH-binding protein (GHBP) is identical to the extracellular domain of the GH receptor (GHR). Because of its origin, GHBP binds GH with the same affinity as GHR and, consequently, GHBP may affect GH bioactivity as well as pharmacokinetics. To improve our knowledge on the complex interaction between GH and GHBP in vivo, we found it of interest to develop a method for determination of free GH. To this end, we developed an ultrafiltration assay that enabled isolation of free GH in undiluted serum during approached in vivo-like conditions. The last part of this review presents our current data on free GH and its interaction with GHBP.
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Affiliation(s)
- J Frystyk
- Medical Research Laboratories, Institute of Clinical Medicine, Faculty of Health Sciences, Aarhus University and Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark.
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Pawlikowska-Haddal A, Cohen P, Cook DM. How useful are serum IGF-I measurements for managing GH replacement therapy in adults and children? Pituitary 2012; 15:126-34. [PMID: 21909971 DOI: 10.1007/s11102-011-0343-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The optimal dosing of growth hormone (GH) therapy is challenging due to high inter-individual variability in subcutaneous GH absorption and sensitivity to the drug. Optimal dosing would maximize patient gains in height, body composition, and metabolic outcomes while minimizing GH adverse events. The pulsatile secretion of GH, however, does not allow direct assessment of circulating GH levels as a measure of response to GH therapy. Insulin-like growth factor (IGF-I), a key marker of GH activity, has been shown to be useful in monitoring and adjusting GH dose during treatment of GH deficiency (GHD). Traditionally, monitoring IGF-I levels in response to GH therapy has been recommended for assessment of treatment compliance and safety. More recently, GH treatment guidelines have stated that IGF-I levels should also be used to guide GH dosing. This review examines whether individualized GH dosing based on the IGF-I response to GH therapy provides a better method for determining the GH replacement needs of pediatric and adult patients compared with conventional GH dosing, and whether IGF-I-based dosing improves outcomes such as height and body composition, with reduced side effects. Because IGF-I measurement presents its own difficulties, the current state of IGF-I assays is also discussed. The reviewed studies show that the use of GH dose adjustments based on IGF-I responses to GH therapy successfully reduces adverse events in adults with GHD and results in greater positive height attainment in children, without increasing adverse events. Long-term outcome studies are needed, as are internationally accepted guidelines for IGF-I measurement.
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Affiliation(s)
- Anna Pawlikowska-Haddal
- Division of Pediatric Endocrinology, Department of Pediatrics, Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, CA, USA
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Åberg D, Jood K, Blomstrand C, Jern C, Nilsson M, Isgaard J, Aberg ND. Serum IGF-I levels correlate to improvement of functional outcome after ischemic stroke. J Clin Endocrinol Metab 2011; 96:E1055-64. [PMID: 21508132 DOI: 10.1210/jc.2010-2802] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
CONTEXT AND OBJECTIVE GH has positive cognitive effects when given to GH-IGF-I-deficient patients. GH and IGF-I exert both neuroprotective and regenerative effects on experimental stroke. We investigated whether the endogenous serum IGF-I (s-IGF-I) levels correlated with recovery of functional independence in patients who had suffered an ischemic stroke. SUBJECTS AND METHODS The s-IGF-I levels were measured in 407 patients (260 males, 147 females) with mean age of 55 (range, 18-69) yr and 40 randomly selected matched controls who were previously included in the Sahlgrenska Academy Study on Ischemic Stroke. Serum samples were collected on two occasions: acutely at 1-10 d (median, 4 d) after stroke and 3 months after the stroke. Recovery after ischemic stroke was evaluated using the modified Rankin scale 3 and 24 months after the stroke, and the Scandinavian Stroke Scale was used for assessments during the acute stage and 3 months after the stroke. RESULTS The s-IGF-I levels were higher in the acute stage than after 3 months and compared with the controls (P < 0.001 and P < 0.01, respectively), and the s-IGF-I levels were progressively lower in the elderly patients. The levels of s-IGF-I in the acute phase and after 3 months both positively correlated with improvement in the modified Rankin scale scores between 3 and 24 months (P = 0.001; r = 0.174, and P < 0.001; r = 0.24, respectively). CONCLUSION A high s-IGF-I during the rehabilitation phase of stroke correlates to better recovery of long-term function.
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Affiliation(s)
- Daniel Åberg
- Laboratory of Experimental Endocrinology, Sahlgrenska University Hospital, The SahlgrenskaAcademy at University of Gothenburg, SE-413 45 Göteborg, Sweden.
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The importance of reference materials in doping-control analysis. Anal Bioanal Chem 2011; 401:483-92. [DOI: 10.1007/s00216-011-5049-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Revised: 04/16/2011] [Accepted: 04/20/2011] [Indexed: 10/18/2022]
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Kovács GL, Dénes J, Hubina E, Kovács L, Czirják S, Góth M. [Consensus on the change of criteria for cure of acromegaly during the last decade]. Orv Hetil 2011; 152:703-8. [PMID: 21498158 DOI: 10.1556/oh.2011.29092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The Acromegaly Consensus Group redefined the consensus criteria for cure of acromegaly. 74 neurosurgeons and experienced endocrinologists summarized the latest results on diagnosis and treatment of acromegaly. In this consensus statement the reliable growth hormone and insulin-like growth factor-1 assays were established. Definition of disease control was discussed based on the available publications and evidence. This short communication summarizes the clinical aspects of consensus criteria for diagnosis and cure of acromegaly based on the original article.
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Affiliation(s)
- Gábor László Kovács
- Honvédkórház-Állami Egészségügyi Központ II. Belgyógyászati Osztály, Endokrinológiai Szakprofil Budapest Podmaniczky u. 111. 1062.
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Clemmons DR. Consensus Statement on the Standardization and Evaluation of Growth Hormone and Insulin-like Growth Factor Assays. Clin Chem 2011; 57:555-9. [DOI: 10.1373/clinchem.2010.150631] [Citation(s) in RCA: 252] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Growth hormone (GH) and insulin-like growth factor I (IGF-I) measurements are widely used in the diagnosis of disorders of GH secretion, evaluation of children with short stature from multiple causes, management of disorders that lead to nutritional insufficiency or catabolism, and monitoring both GH and IGF-I replacement therapy. Therefore, there is an ongoing need for accurate and precise measurements of these 2 peptide hormones. Representatives of the Growth Hormone Research Society, the IGF Society, and the IFCC convened an international workshop to review assay standardization, requirements for improving assay comparability, variables that affect assay interpretation, technical factors affecting assay performance, assay validation criteria, and the development and use of normative data. Special attention was given to preanalytical conditions, the use of international commutable reference standards, antibody specificity, matrix requirements, QC analysis, and interference by binding proteins. Recommendations for each of these variables were made for measurements of each peptide. Additionally, specific criteria for IGF-I were recommended for age ranges of normative data, consideration of Tanner staging, and consideration of the effect of body mass index. The consensus statement concludes that major improvements are necessary in the areas of assay performance and comparability. This group recommends that a commutable standard for each assay be implemented for worldwide use and that its recommendations be applied to accomplish the task of providing reliable and clinically useful results.
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Affiliation(s)
- David R Clemmons
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
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Abstract
Although recombinant human GH (rhGH) has been available since 1985, there are several questions related to its use that remain unanswered. The Entrez-PubMed search engine was used to conduct a review of publications appearing since 2007 that address growth and GH treatment. Recent publications related to the diagnosis of GH deficiency, genetics of growth, the use of rhGH in different genetic conditions, in idiopathic short stature, and in puberty, and strategies to adjust rhGH dose were reviewed. New studies investigating the genetics of growth and the response to rhGH therapy in different groups are helping in the understanding of the physiology of normal growth. Although in most children treated with rhGH there is a short-term benefit, the clinical relevance of the benefits after long-term treatment in some conditions remains unclear. The challenges are to define milder forms of GH deficiency and to assess the relevance of the benefits, if any, caused by rhGH in different patient populations and the best therapeutic approach for these patients. Well-designed long-term studies using anthropometric, genetic, and laboratory data that will also assess long-term quality of life benefits are needed to help clinicians select patients to initiate treatment with rhGH and to adjust treatment to improve outcome.
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Clinical laboratory indices in the treatment of acromegaly. Clin Chim Acta 2010; 412:403-9. [PMID: 21075098 DOI: 10.1016/j.cca.2010.11.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Revised: 11/04/2010] [Accepted: 11/05/2010] [Indexed: 11/23/2022]
Abstract
Measurement of serum growth hormone (GH) and insulin-like growth factor-I (IGF-) is used to monitor the degree of improvement that occurs following treatment of patients with acromegaly. Improvement in GH assay sensitivity has led to changes in the definition of normal GH however many studies that assess the predictive value of GH were conducted in an era where assays were less sensitive. Other problems that have occurred with GH measurements include utilization of different standards and failure to prove commutability of commonly accepted standard. GH reference ranges vary in their quality and are not stratified for age, sex or body mass index. IGF-I measurements are associated with similar problems. They do not use a common standard that has been proven to be commutable and results can vary widely when the same specimens are assayed in different laboratories. Although age and sex stratified reference ranges exist, these do not always have adequate numbers of subjects and BMI adjusted ranges are not available. These problems have led to significant discordance in a significant number of patients wherein the IGF-I and GH values may yield a discrepant prediction of disease stabilization. In these cases in general the IGF-I values correlate better with the presence of persistent symptoms. Patients who fail to suppress GH to normal but have a normal IGF-I have to be monitored carefully for recurrence but usually do not require further therapy if they are asymptomatic. For the long term assessment of outcome and clinical disease activity measurement of both hormones is recommended.
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Massart C, Poirier JY. Determination of serum insulin-like growth factor-I reference values for the automated chemiluminescent Liaison® assay. Clinical utility in the follow-up of patients with treated acromegaly. Clin Chim Acta 2010; 412:398-9. [PMID: 21059350 DOI: 10.1016/j.cca.2010.10.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Revised: 10/11/2010] [Accepted: 10/29/2010] [Indexed: 10/18/2022]
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Banfi G, Lombardi G, Colombini A, Lippi G. A world apart. Clin Chim Acta 2010; 411:1003-8. [DOI: 10.1016/j.cca.2010.03.039] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Revised: 03/24/2010] [Accepted: 03/27/2010] [Indexed: 01/28/2023]
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Giustina A, Chanson P, Bronstein MD, Klibanski A, Lamberts S, Casanueva FF, Trainer P, Ghigo E, Ho K, Melmed S. A consensus on criteria for cure of acromegaly. J Clin Endocrinol Metab 2010; 95:3141-8. [PMID: 20410227 DOI: 10.1210/jc.2009-2670] [Citation(s) in RCA: 593] [Impact Index Per Article: 42.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The Acromegaly Consensus Group met in April 2009 to revisit the guidelines on criteria for cure as defined in 2000. PARTICIPANTS Participants included 74 neurosurgeons and endocrinologists with extensive experience of treating acromegaly. EVIDENCE/CONSENSUS PROCESS: Relevant assays, biochemical measures, clinical outcomes, and definition of disease control were discussed, based on the available published evidence, and the strength of consensus statements was rated. CONCLUSIONS Criteria to define active acromegaly and disease control were agreed, and several significant changes were made to the 2000 guidelines. Appropriate methods of measuring and achieving disease control were summarized.
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Affiliation(s)
- A Giustina
- Department of Medical and Surgical Sciences, University of Brescia, Endocrine Service, Montichiari Hospital, Via Ciotti 154, 25018 Montichiari, Italy.
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Frystyk J, Freda P, Clemmons DR. The current status of IGF-I assays--a 2009 update. Growth Horm IGF Res 2010; 20:8-18. [PMID: 19818658 PMCID: PMC7748085 DOI: 10.1016/j.ghir.2009.09.004] [Citation(s) in RCA: 114] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2009] [Accepted: 09/16/2009] [Indexed: 10/20/2022]
Abstract
For almost three decades, the measurement of circulating IGF-I has constituted a highly important biochemical tool in the management of GH disorders. In fact, in acromegaly the importance of circulating IGF-I has increased following the introduction of the GH receptor antagonist pegvisomant, as the use of this drug makes it impossible to use circulating GH as a monitor of disease activity. In addition, determination of circulating IGF-I constitutes a valuable scientific tool in various research areas, from epidemiological investigations through clinical trials and experimental studies. The multiple facets of IGF-I physiology and patho-physiology may explain why numerous endocrine laboratories have invested in IGF-I assays, by means of either in-house assays or commercial kits. However, despite its widespread use, the measurement of IGF-I is by no means trivial. On the contrary, the pronounced binding of IGF-I to the high-affinity IGF-binding proteins (IGFBPs) constitutes a notorious source of error, which has necessitated the development of methods that more or less successfully circumvent interference from the IGFBPs. Furthermore, there are some unsolved issues with the international standardization of the different IGF-I assays and there is no consensus regarding the procedures used when collecting and storing samples for measurement of circulating IGF-I. The aim of this review is to discuss the current state of the art of IGF-I immunoassays and to present the current analytical problems with IGF-I measurements. Finally, we would like to suggest an agenda that may be used when trying to produce internationally accepted uniform requirements for future IGF-I assays.
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Affiliation(s)
- Jan Frystyk
- The Medical Research Laboratories, Clinical Institute of Medicine, and Medical Department M (Diabetes & Endocrinology), Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark.
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Abstract
Two important biomarkers for the identification of growth hormone or IGF-I administration are IGF-I and P-III-P. These substances are determined in plasma or preferably in serum. There are a number of assays on the market for IGF-I but only two for P-III-P. The principles behind these assays and the choice of assays for doping control purposes are discussed. The future possibility of quantification by mass spectrometry is also briefly discussed.
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Affiliation(s)
- David A Cowan
- Drug Control Centre, Department of Forensic Science and Drug Monitoring, King's College London, London SE1 9NH, United Kingdom.
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