ECE2022 Eposter Presentations Pituitary and Neuroendocrinology (211 abstracts)
Age and puberty based IGF-1 normative data in healthy children from North India.
Bhanu Malhotra 1 , Kv Ravi Teja 1 , Sanjay Bhadada 1 , Ashu Rastogi 1 , Anil Bhansali 1 , Naresh Sachdeva 1 , Ranjana Walker Minz 1 , Rama Walia 1 , Mahesh Prakash 1 , Arun Kumar Aggarwal 1 , Gajinder Dewan 2 , Liza Das 1 , Philip Monaghan 3 , Peter Trainer 3 , Marta Korbonits 4 , Raman Kumar Marwaha 5 & Pinaki Dutta 1
1PGIMER, Endocrinology, Chandigarh, India; 2GMSH-16, Chandigarh, India; 3Christie NHS Foundation Trust, Manchester, United Kingdom; 4William Harvey Research Institute at Barts and the London School of Medicine, Queen Mary University of London, Endocrinology, London, United Kingdom; 5SEHEAC, New Delhi, India
Context: Serum IGF-1 levels are of paramount importance for diagnosis and management of growth related disorders. The reference range of IGF- 1 should be ethnicity and Tanner specific. Indian data on the same is scarce and there is a need to develop the same.
Objective: To develop age, sex and Tanner based normative reference range of serum IGF-1 level for Indian children and correlate the same with peri-pubertal hormonal parameters.
Setting and participants: After excluding children with short stature, anemia, chronic systemic illnesses, underlying endocrinopathies and celiac disease; 1929 children (916 girls, 1013 boys) were eligible for participation out of 2191 children screened. They were stratified as per chronological age and pubertal stage (Marshall and Tanner).
Outcome measures: Serum IGF-1 was measured by in house electrochemiluminescence immunoassay by Roche Diagnostics (cobas e 801) Mannheim, Germany; at PGIMER, Chandigarh. External validation of assay was done by robust immunodiagnostics method (iSYS) at Manchester, UK. Normative reference range and correlation were obtained based on Roche method.
Result: Serum IGF-1 levels peaked at chronological age of 13 years (median 50thcentile 397.38 ng/ml) [Greulich Pyle BA 14 years(389 ng/ml)] in girls and at 15 years in boys (327 ng/ml) [BA 16 years (370 ng/ml)], followed by a decline to nadir at 18 years in both. Girls had an early peaking of IGF-1 as compared to boys. The median IGF-1 levels in girls increased from Tanner stage 1 to stage 4, with peak value of 345 ng/ml at stage 4 and declining sharply thereafter. For boys, levels increased from Tanner stage 1 to stage 3, peaked at 308 ng/ml at stage 3, after which the levels were stable and fluctuated around the peak from stage 3 to 5. IGF-1 also correlated significantly with hormonal parameters of puberty (girls: LH (r =0.52), estradiol (r=0.40), DHEAS (r = 0.44); boys: LH (r= 0.57), testosterone (r=0.56), DHEAS (r=0.47); with LH showing the best correlation. This early peaking of IGF- 1 levels in the present study vis-a vis Caucasians (14-16 years) has also been reported in other studies from Asia (11-13 years).
Conclusion: Along with chronological age, Tanner based reference range will further improve the diagnostic utility of IGF-1 normative data in school going children.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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