Utility of insulin-like growth factor-1 (IGF-1) in growth hormone-treated short children – An experience from a tertiary level center

Introduction: Very few studies have been conducted in low-middle-income countries to assess the response to growth hormone (GH) therapy by measuring the improvement in insulin-like growth factor-1 (IGF-1) concentrations. Objectives: The objective is to assess IGF-1 concentrations in patients receiving GH therapy to correlate the height increment with respect to increase in the IGF-1 concentrations, including IGF-1 Z-scores as a measure of safety profile. Methods: Clinical and anthropometric data were extracted retrospectively from hospital records of children aged 0–18 who received GH and had IGF-1 measured during the study period. Serum IGF-1 concentrations were analyzed by a solid-phase enzyme-linked immunosorbent assay. Patients with GH deficiency (GHD) and multiple pituitary hormone deficiency (MPHD) were grouped as group A, while participants receiving GH therapy for non-GHD/MPHD were clubbed as group B. Results: We report a significant positive correlation between an increase in IGF-1 values and increase in height. The improvement in height Z-scores was significantly higher in participants of group A as compared to B, with no significant difference in increase in IGF-1 Z-scores between the two groups. A total of 18.75% of subjects had IGF-1 Z-scores between +2 and +3, and these were largely subjects belonging to group B. Conclusion: The increment in height and height velocity Z-scores in the patients on GH correlated with increase in the IGF-1 concentrations, particularly in GHD/MPHD group of patients.