ESPE2024 Poster Category 2 Late Breaking (107 abstracts)
The IGF1 generation test as a tool to predict growth response to growth hormone treatment in children with growth hormone deficiency
Sakina Kherra 1,2 , Yasmine Ouarezki 3 , Adel Djermane 3 , Hassiba Sahli 1 , Latifa Sifour 4 , Sihem Bellouti 1 , Kahina Mohamedi 5 , Noureddine Boutaghane 1 , Fadila Bouferoua 6 , Meriem Bensalah 7 , Asmahane Ladjouze 4 , Belaid Ait abdelkadder 8 , Régis Coutant 9 & Zeroual Zoulikha 1
1CHU Hussein Dey, Algiers, Algeria. 2Pediatric Unit, Algiers, Algeria. 3Hassan Badi Hospital, Algiers, Algeria. 4CHU Lamine Debaghine, Algiers, Algeria. 5Ain Taya Hospital, Algiers, Algeria. 6CHU Benimessous, Algiers, Algeria. 7CHU Ain Nadja, Algiers, Algeria. 8CHU Mustapha, Algiers, Algeria. 9CHU Angers, Angers, France
Introduction: Serum levels of insulin growth factor (IGF1) could be a good indicator of growth hormone (GH) sensitivity and potentially GH therapy responsiveness. Few studies analyzed IGF1 generation test as predictor factor of the growth response to GH treatment in children with growth hormone deficiency (GHD) but results were controversial.
Objective: The aimof the study was to evaluate the IGF-I generation test (IGF-I gen) as a tool to predict growth hormone response in children with GHD.
Methods: In this prospective study, 144 GH deficient children were included and treated with recombinant growth hormone (rGH) for one year. Concerning the IGF1 gen test, rGH was administered during 7 days at a mean posology of 0.030 mg/kg/day and serum IGF-I level was measured prior to and at day 7 of rGH treatment. The statural gain (ΔHT SD) during the first year of treatment was compared and correlated to the delta IGF1 variability: ΔIGF1 in % and standard deviation (SD). According to the Ranke criteria, a good response is defined as (HT SD ≥ 0.5 SD)
Results: After 01 year of treatment, 2 groups were defined: GHD-1 subgroup (n = 99) had a good response to rGH (ΔHT SD ≥ 0,5 SD), while those in the GHD-2 subgroup (n = 45) had a poor response (ΔHT SD < 0,5 SD). The group of children with GHD-1 and GHD-2 had low baseline IGF-I values (mean: 78.59 ± 63.34 ng/ml: -2.35 ± 0.94 SD versus 87.73 ± 52.7 ng/ml: -2.29 ± 1.10 SD) respectively, but their peak IGF-I values during the IGF-I generation test was higher in the group with good response: 176,92 ± 109,80 ng/ml (- 0,67 ± 1,01 SD) versus 147,94 ± 63,67 ng/ml (- 1,11 ± 0,96 SD) in the second group. The variability of IGF1 % during the test was greater in the good response GHD groups than in the poor response GHD group; 98,32 ± 77,48 % in the GHD-1, versus: 60,21 ± 39,43% in GHD-2 (P = 0,002). With similar IGF1 variability in SD: 1,67 ± 1,04 SD in the GHD-1, versus 1,17 ± 0,97 SD in GHD-2, (P = 0,006). An optimal prediction threshold of +1 SD was defined by the ROC curve with a sensitivity of 71%.
Conclusion: The IGF-I response during the IGF-I generation test seems to predict the growth hormone response to rGH treatment in children with GHD.
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