ECEESPE2025 Poster Presentations Growth Axis and Syndromes (91 abstracts)
Total and bioactive IGF-i in healthy children and adolescents and in short children during growth hormone therapy: an alternative tool to individualized GH treatment in patients
Lea Vilmann1, Jørgen Petersen1, Stine Agergaard Holmboe1, Peter Christiansen1, Katharina M. Main1, 2, Line Cleemann1, Kristian Hansen3, Jan Frystyk3, 4, Casper Hagen1, 2 & Anders Juul1, 2
1Copenhagen University Hospital, Rigshospitalet, Department of Growth and Reproduction, Copenhagen, Denmark; 2University of Copenhagen, Department of Clinical Medicine, Copenhagen, Denmark; 3OPEN Lab, Odense University Hospital, OPEN Lab, Odense, Denmark; 4Endocrine Research Unit, Odense University Hospital, Department of Endocrinology, Odense, Denmark
JOINT1400
Background: The growth response following recombinant human growth hormone treatment (rhGH) varies. Accordingly, titration of doses is often based on assessment of serum total IGF-I. However, in a recent study of SGA children, serum levels of bioactive IGF (bio-IGF) were lower than total IGF-I, indicating a therapeutic opportunity for increasing the dose of rhGH.
Aims: To assess if bio-IGF could be a clinically relevant biomarker, helping to titrate the dose of rhGH, we determined serum bio-IGF reference ranges in patients with short stature due to various conditions.
Method: Reference population: A cohort of 570 healthy children and adolescents (59% girls) from an ongoing study (COPUS III). GH treated children: In total, 130 patients (35% girls) enrolled during 2024. Patients included subgroups of: GH deficiency (GHD), small for gestational age (SGA), Turner (TS), Prader Willi syndrome (PWS), Chronic Renal Insufficiency (CRI) or Other. In 128 children, blood samples were collected once during rhGH. All samples were analyzed for bio-IGF (KIRA assay) and total IGF-I (iSYS).
Results: In healthy girls and boys, bio-IGF increased with age and peaked at mid-puberty (Tanner-stage, mean (range)): B3, 1. 35 (0. 57-4. 03) µg/l and G3, 1. 25 (0. 44-2. 45) µg/l, respectively. Total and bio-IGF correlated significantly in healthy boys: Pearson r = 0. 60, healthy girls: r=. 55, GH treated boys: r = 0. 76 and GH treated girls: r = 0. 61. In children receiving rhGH, the prevalence of concentrations exceeding +2SD was higher for total IGF-I compared to bio-IGF (25% vs. 13%), especially in non-GHD patients (Table 1).
| Subgroups (n) | Bio IGF SD | IGF-I SD |
| GHD (75) | 1. 07 (-2. 63-6. 09) | 1. 08 (-2. 79-4. 04) |
| SGA (21) | 1. 06 (-0. 86-3. 52) | 1. 88 (-1. 37-3. 42) |
| Turner (7) | 0. 12 (-2. 88-2. 15) | 1. 55 (-1. 06-2. 79) |
| PWS (7) | . 85 (-0. 05-1. 80) | 2. 06 (0. 40-2. 66) |
| CRI (4) | 1. 24 (0. 81-1. 80) | 1. 41 (0. 20-1. 86) |
| Other diagnoses (14) | 0. 85 (-0. 48-1. 42) | 1. 41 (0. 45-2. 40)* |
| All diagnoses (128) | 1. 05 (-2. 88-6. 09) | 1. 27 (-2. 79-4. 04) |
| All non-GHD diagnoses (53) | 1. 00 (-2. 88-3. 52) | 1. 55 (-1. 37-3. 42)* |
| MWU: Mann-Whitney U test, *P-value<0. 05 | ||
Conclusion: Reassuringly, most non-GHD patients had IGF bioactivity within references based on healthy age-matched children, despite 25% of subjects having total IGF-I concentrations above +2SD. Further studies are needed to evaluate the clinical value of bio-IGF as an alternative biomarker in short children receiving GH treatment.
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