The introduction of the IDSiSYS total IGF1 assay may have farreaching consequences for diagnosis and treatment of GH deficiency

A. J. Varewijck, S. W.J. Lamberts, A. J. Van Der Lely, S. J.C.M.M. Neggers, L. J. Hofland, J. A.M.J.L. Janssen

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15 Citaten (Scopus)

Samenvatting

Context: IGF-1 measurements are used for screening and monitoring GH deficiency (GHD) and acromegaly. Objective: Our objective was to study whether the introduction of the IDS-iSYS IGF-1 assay would lead to different clinical interpretations in GHD and acromegaly. Design: In 106 GHD subjects and in 15 acromegalic subjects visiting our university hospital, total IGF-1 levels were measured before and during therapy by using the Immulite (IM) assay and IDS-iSYS (ID) assay. Z-scores were calculated by using assay-specific age-specific normative range values. All treatment decisions were based upon results obtained by the IM assay. Results: In GHD subjects, absolute IGF-1 concentrations differed significantly between both IGF-1 assays before treatment (P < .001) but not during GH treatment (P = .32), and mean Z-scores for IGF-1 differed significantly before starting (IM, -2.23, vs ID, -1.43; P < .001) and during GH treatment (IM,-0.60, vs ID,+0.21; P<.001). In acromegalic subjects, absolute IGF-1 concentrations did not differ between both IGF-1 assays before treatment (P=.18) but were significantly different during treatment (P = 0.009), and mean Z-scores for IGF-1 were not different before starting (IM, 10.93, vs ID, 10.78; P = .41) or during treatment (IM, 3.60, vs ID, 3.18; P = .23). Conclusions: In GHD subjects, mean IGF-1 Z-scores significantly differed when measured by the IM assay compared with the ID assay irrespective of treatment. In contrast, in acromegaly, mean IGF-1 Z-scores did not differ significantly between both assays. Our study suggests that replacement of the IM assay by the ID assay may have far-reaching consequences for the clinical diagnosis and treatment of GHD.

Originele taal-2Engels
Pagina's (van-tot)309-316
Aantal pagina's8
TijdschriftJournal of Clinical Endocrinology and Metabolism
Volume100
Nummer van het tijdschrift1
DOI's
StatusGepubliceerd - 1 jan. 2015
Extern gepubliceerdJa

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