ObjectiveTo explore the clinical application value of growth hormone-insulin-like growth factors(GH/IGFs) axis function detection in the etiological diagnosis of short stature children.

MethodsNinety children with short stature in the pre-puberty stage(P1 by Tanner stage) and 50 healthy children were divided into the observation group and control group, respectively.The levels of serum insulin-like growth factor-1(IGF-1) and insulin-like growth factor binding protein-3(IGFBP-3) in two groups were measured.The pathogenesis in the observation group were diagnosed using GH challenge test, and the observation group was divided into the complete GH deficiency(CGHD) group, partial GH deficiency(PGHD) group and idiopathic short stature(ISS) group.The sensitivity, specificity and accuracy of serum IGF-1 and IGFBP-3 in the diagnosis of short stature were analyzed.

ResultsAccording to the results of GH challenge test, there were 22 patients in CGHD group, 36 patients in PGHD group and 32 patients in ISS group.The serum levels of IGF-1 and IGFBP-3 in CGHD group, PGHD group and ISS group were significantly lower than those in control group(P < 0.01), and the serum levels of IGF-1 and IGFBP-3 in CGHD group were significantly lower than those in PGHD group and ISS group(P < 0.01).With the serum level of IGF-1 < 52.8 ng/mL as the judgment value, the sensitivity, specificity and accuracy of CGHD diagnosis were 81.82%, 100.00% and 95.56%, respectively.With the serum level of IGFBP-3 < 3.12 μg/mL as the judgment value, the sensitivity, specificity and accuracy of CGHD prognosis were 100.00%, 75.00% and 81.11%, respectively.

ConclusionsThe GH/IGF axis function detection has high clinical value in the etiological diagnosis of children with short stature.The detection of serum IGF-1 and IGFBP-3 may contribute to the primary screening of CGHD, and which combining with GH challenge test may be more helpful to the diagnosis of PGHD and ISS.