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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, The Introduction of the IDS-iSYS Total IGF-1 Assay May Have Far-Reaching Consequences for Diagnosis and Treatment of GH Deficiency, The Journal of Clinical Endocrinology & Metabolism, Volume 100, Issue 1, 1 January 2015, Pages 309–316, https://doi.org/10.1210/jc.2014-2558
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Abstract
IGF-1 measurements are used for screening and monitoring GH deficiency (GHD) and acromegaly.
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.
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.
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).
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.
