1
|
Moreno-Parro I, Diaz-Garzon J, Aarsand AK, Sandberg S, Aikin R, Equey T, Ríos-Blanco JJ, Buño Soto A, Fernandez-Calle P. Biological Variation Data in Triathletes for Metabolism and Growth-Related Biomarkers Included in the Athlete Biological Passport. Clin Chem 2024:hvae072. [PMID: 38781424 DOI: 10.1093/clinchem/hvae072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/08/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND When using biological variation (BV) data, BV estimates need to be robust and representative. High-endurance athletes represent a population under special physiological conditions, which could influence BV estimates. Our study aimed to estimate BV in athletes for metabolism and growth-related biomarkers involved in the Athlete Biological Passport (ABP), by 2 different statistical models. METHODS Thirty triathletes were sampled monthly for 11 months. The samples were analyzed for human growth hormone (hGH), insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein 3 (IGFBP-3), insulin, and N-terminal propeptide of type III procollagen (P-III-NP) by immunoassay. Bayesian and ANOVA methods were applied to estimate within-subject (CVI) and between-subject BV. RESULTS CVI estimates ranged from 7.8% for IGFBP-3 to 27.0% for insulin, when derived by the Bayesian method. The 2 models gave similar results, except for P-III-NP. Data were heterogeneously distributed for P-III-NP for the overall population and in females for IGF-1 and IGFBP-3. BV components were not estimated for hGH due to lack of steady state. The index of individuality was below 0.6 for all measurands, except for insulin. CONCLUSIONS In an athlete population, to apply a common CVI for insulin would be appropriate, but for IGF-1 and IGFBP-3 gender-specific estimates should be applied. P-III-NP data were heterogeneously distributed and using a mean CVI may not be representative for the population. The high degree of individuality for IGF-1, IGFBP-3, and P-III-NP makes them good candidates to be interpreted through reference change values and the ABP.
Collapse
Affiliation(s)
- Isabel Moreno-Parro
- Department of Laboratory Medicine, La Paz University Hospital, Madrid, Spain
- IdiPaz-Hospital La Paz Institute for Health Research, Madrid, Spain
| | - Jorge Diaz-Garzon
- Department of Laboratory Medicine, La Paz University Hospital, Madrid, Spain
- IdiPaz-Hospital La Paz Institute for Health Research, Madrid, Spain
| | - Aasne K Aarsand
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
- Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Sverre Sandberg
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
- Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Reid Aikin
- World Anti-Doping Agency (WADA), Montreal, Quebec, Canada
| | - Tristan Equey
- World Anti-Doping Agency (WADA), Montreal, Quebec, Canada
| | - Juan José Ríos-Blanco
- IdiPaz-Hospital La Paz Institute for Health Research, Madrid, Spain
- Department of Internal Medicine, La Paz University Hospital, Madrid, Spain
| | - Antonio Buño Soto
- Department of Laboratory Medicine, La Paz University Hospital, Madrid, Spain
- IdiPaz-Hospital La Paz Institute for Health Research, Madrid, Spain
| | - Pilar Fernandez-Calle
- Department of Laboratory Medicine, La Paz University Hospital, Madrid, Spain
- IdiPaz-Hospital La Paz Institute for Health Research, Madrid, Spain
| |
Collapse
|
2
|
Lyall K, Rando J, Toroni B, Ezeh T, Constantino JN, Croen LA, Garvin B, Piselli K, Connell J, Kaat AJ, Newschaffer CJ. Examining shortened versions of the Social Responsiveness Scale for use in autism spectrum disorder prediction and as a quantitative trait measure: Results from a validation study of 3-5 year old children. JCPP ADVANCES 2022; 2:e12106. [PMID: 36741204 PMCID: PMC9890399 DOI: 10.1002/jcv2.12106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 09/08/2022] [Indexed: 12/15/2022] Open
Abstract
Background The Social Responsiveness Scale (SRS) is a 65-item measure yielding a continuous score capturing autism-related traits. Scores based on SRS item subsets have been analytically examined but administration of shortened versions has not been evaluated prospectively. Objective The goal of this study was to compare psychometric properties of two shortened versions of the SRS to the full 65-item SRS, in young children from both a clinical and general population setting. Methods Study participants (aged 3-5 years) were drawn from the AJ Drexel Autism Institute clinic (n = 154) and Kaiser Permanente Northern California (n = 201) and block randomized to receive either the 16-item short SRS, a newly developed computer adaptive testing-SRS, or the published full-length SRS. Total scores across the three SRS administration methods were scaled to facilitate comparisons. Scores were plotted to assess distributional properties, while Receiver Operating Characteristic analysis was used to estimate Area Under the Curve (AUC) and address predictive ability. Results Overall, distributional properties of the three administration methods were highly comparable, with shortened measures demonstrating similar ability to capture the range of the distribution and case non-case separation as the full SRS. In addition, AUC values were high (0.91-0.97) and comparable across the administration methods, though there was evidence of difference in predictive ability across measures for females (AUC for full SRS = 0.99 vs. 0.84 for short). Within individual comparisons of short versus full scores (available only for participants at the general population site) suggested underestimation of actual full SRS scores with the CAT-SRS. Conclusions Our findings broadly support the construct validity and performance of shortened SRS versions examined here, though the full measure may be needed to more accurately assess traits consistent with ASD diagnosis in females. This work suggests opportunities for collection of ASD-related phenotype in settings where participant burden or feasibility considerations may have otherwise prohibited such measurement.
Collapse
Affiliation(s)
- Kristen Lyall
- AJ Drexel Autism Institute Drexel University Philadelphia Pennsylvania USA.,Department of Epidemiology and Biostatistics Dornsife School of Public Health Drexel University Philadelphia Pennsylvania USA
| | - Juliette Rando
- AJ Drexel Autism Institute Drexel University Philadelphia Pennsylvania USA
| | - Bridget Toroni
- AJ Drexel Autism Institute Drexel University Philadelphia Pennsylvania USA
| | - Tobechukwu Ezeh
- Department of Epidemiology and Biostatistics Dornsife School of Public Health Drexel University Philadelphia Pennsylvania USA
| | | | - Lisa A Croen
- Division of Research Kaiser Permanente Oakland California USA
| | - Brigid Garvin
- AJ Drexel Autism Institute Drexel University Philadelphia Pennsylvania USA
| | - Kate Piselli
- AJ Drexel Autism Institute Drexel University Philadelphia Pennsylvania USA
| | - James Connell
- School of Education Drexel University Philadelphia Pennsylvania USA
| | - Aaron J Kaat
- Department of Medical Social Sciences Feinberg School of Medicine Northwestern University Chicago Illinois USA
| | - Craig J Newschaffer
- College of Health and Human Development Pennsylvania State University Philadelphia PennsylvaniaPA USA
| | | |
Collapse
|
3
|
Bidlingmaier M, Valcour A, Schilbach K, Kuehnle T, Diederich S, Rogge T, Cavalier E, Katayev A. Differences in the distribution of insulin-like growth-factor-I (IGF-I) concentrations between European and US populations. J Endocr Soc 2022; 6:bvac081. [PMID: 35673402 PMCID: PMC9165432 DOI: 10.1210/jendso/bvac081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Indexed: 11/19/2022] Open
Abstract
Abstract
Context
Method-specific reference intervals (RIs) determine utility of IGF-I as a biomarker in growth hormone-related diseases. Differences between populations might affect applicability of RIs.
Objective
To compare population-specific RIs derived from IGF-I routine testing in laboratories in the US and Europe using the same assay.
Design and setting
Uncensored routine IGF-I testing results generated over 5 years in four accredited laboratories (US, n=778,173 males/710,752 females; Europe, n=23,220 males/40,183 females).
Main outcome measures
Construction of RIs by indirect statistical methods designed to utilize routine testing data (modified Hoffmann approach). Comparison to published RIs, between the US and Europe, and between regions in the US with lower and higher mean body mass indexes (BMIs).
Results
Lower limits (LLs) of RIs calculated from all routine data sets do not differ from the published LLs. The same is true for Upper limits (ULs) calculated from European routine data. ULs derived from US routine data are significantly higher (children (10–18 years [mean, %]: boys +149.3 ng/mL [+34.6%]; girls +94.9 ng/mL [+19.8%]); adults (19–95 years: males +45 ng/mL [+20.3%]; females +29.7 ng/mL [+13.8%])). Average IGF-I is higher in samples from Colorado (lower mean BMI) compared with Alabama (p <0.0001), although the difference is smaller than between each of them and Europe.
Conclusions
We provide evidence that in large datasets from the same population, direct sampling and the indirect Hoffmann approach provide comparable RIs. While LLs are comparable between Europe and the US, the UL is significantly higher in the US. We suggest use of adapted RIs for the US.
Collapse
Affiliation(s)
- Martin Bidlingmaier
- Endocrine Laboratory, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
| | - Andre Valcour
- Laboratory Corporation of America Holdings, North Carolina, USA
| | - Katharina Schilbach
- Endocrine Laboratory, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
| | - Tim Kuehnle
- Endocrine Laboratory, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
| | | | | | | | - Alex Katayev
- Laboratory Corporation of America Holdings, North Carolina, USA
| |
Collapse
|
4
|
Equey T, Pastor A, de la Torre Fornell R, Thomas A, Giraud S, Thevis M, Kuuranne T, Baume N, Barroso O, Aikin R. Application of the Athlete Biological Passport Approach to the Detection of Growth Hormone Doping. J Clin Endocrinol Metab 2022; 107:649-659. [PMID: 34726230 DOI: 10.1210/clinem/dgab799] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Because of its anabolic and lipolytic properties, growth hormone (GH) use is prohibited in sport. Two methods based on population-derived decision limits are currently used to detect human GH (hGH) abuse: the hGH Biomarkers Test and the Isoforms Differential Immunoassay. OBJECTIVE We tested the hypothesis that longitudinal profiling of hGH biomarkers through application of the Athlete Biological Passport (ABP) has the potential to flag hGH abuse. METHODS Insulin-like growth factor 1 (IGF-1) and procollagen III peptide (P-III-NP) distributions were obtained from 7 years of anti-doping data in elite athletes (n = 11 455) and applied as priors to analyze individual profiles from an hGH administration study in recreational athletes (n = 35). An open-label, randomized, single-site, placebo-controlled administration study was carried out with individuals randomly assigned to 4 arms: placebo, or 3 different doses of recombinant hGH. Serum samples were analyzed for IGF-1, P-III-NP, and hGH isoforms and the performance of a longitudinal, ABP-based approach was evaluated. RESULTS An ABP-based approach set at a 99% specificity level flagged 20/27 individuals receiving hGH treatment, including 17/27 individuals after cessation of the treatment. ABP sensitivity ranged from 12.5% to 71.4% across the hGH concentrations tested following 7 days of treatment, peaking at 57.1% to 100% after 21 days of treatment, and was maintained between 37.5% and 71.4% for the low and high dose groups 1 week after cessation of treatment. CONCLUSION These findings demonstrate that longitudinal profiling of hGH biomarkers can provide suitable performance characteristics for use in anti-doping programs.
Collapse
Affiliation(s)
- Tristan Equey
- World Anti-Doping Agency (WADA), Montreal, Quebec, Canada
| | - Antoni Pastor
- Integrative Pharmacology and Systems Neuroscience Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBEROBN), Madrid, Spain
- University Pompeu Fabra (CEXS-UPF), Barcelona, Spain
| | - Rafael de la Torre Fornell
- Integrative Pharmacology and Systems Neuroscience Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBEROBN), Madrid, Spain
- University Pompeu Fabra (CEXS-UPF), Barcelona, Spain
| | - Andreas Thomas
- Institute of Biochemistry, German Sport University Cologne, Cologne, Germany
| | - Sylvain Giraud
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Genève and Lausanne, Centre Hospitalier Universitaire Vaudois and University of Lausanne, 1066 Epalinges, Switzerland
| | - Mario Thevis
- Institute of Biochemistry, German Sport University Cologne, Cologne, Germany
| | - Tiia Kuuranne
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Genève and Lausanne, Centre Hospitalier Universitaire Vaudois and University of Lausanne, 1066 Epalinges, Switzerland
| | - Norbert Baume
- World Anti-Doping Agency (WADA), Montreal, Quebec, Canada
| | - Osquel Barroso
- World Anti-Doping Agency (WADA), Montreal, Quebec, Canada
| | - Reid Aikin
- World Anti-Doping Agency (WADA), Montreal, Quebec, Canada
| |
Collapse
|
5
|
Gaddas M. Le dosage de l’Insulin-Like Growth Factor-1 : les difficultés de la détermination sérique et de l’interprétation des résultats. NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2021.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
6
|
Stelmachowska-Banaś M, Czajka-Oraniec I, Tomasik A, Zgliczyński W. Real-world experience with pasireotide-LAR in resistant acromegaly: a single center 1-year observation. Pituitary 2022; 25:180-190. [PMID: 34498217 PMCID: PMC8821488 DOI: 10.1007/s11102-021-01185-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/26/2021] [Indexed: 10/26/2022]
Abstract
CONTEXT Pasireotide-LAR, a second-generation somatostatin receptor ligand (SRL), is recommended for patients with acromegaly as second-line treatment. Its efficacy and safety were assessed in clinical trials; however, the real-world evidence is still scarce. OBJECTIVE The aim of this study was to evaluate the impact of 1-year treatment with pasireotide-LAR on disease control and glucose metabolism in acromegaly patients resistant to first-generation SRLs. DESIGN A single-center prospective study. METHODS Twenty-eight patients with active acromegaly or acrogigantism on first-generation SRLs following ineffective pituitary surgery were switched to treatment with pasireotide-LAR 40 or 60 mg i.m. every 28 days. To assess the efficacy of the treatment GH and IGF-1 levels were measured every 3 months. Safety of treatment was carefully evaluated, especially its impact on glucose metabolism. RESULTS Complete biochemical control (GH ≤ 1 ng/mL and IGF-1 ≤ 1 × ULN) was achieved in 26.9% of patients and partial + complete response (GH ≤ 2.5 ng/mL and IGF-1 ≤ 1.3 × ULN) in 50.0% of patients. Mean GH level decrease was the largest within first 6 months (P = 0.0001) and mean IGF-1 level decreased rapidly within the first 3 months (P < 0.0001) and they remained reduced during the study. Blood glucose and HbA1c levels increased significantly within 3 months (P = 0.0001) and stayed on stable level thereafter. Otherwise, the treatment was well tolerated and clinical improvement was noticed in majority of patients. CONCLUSIONS This real-life study confirmed good effectiveness of pasireotide-LAR in patients resistant to first-generation SRLs. Pasireotide-LAR was overall safe and well tolerated, however significant glucose metabolism worsening was noted.
Collapse
Affiliation(s)
| | | | - Agnieszka Tomasik
- Department of Endocrinology, The Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Wojciech Zgliczyński
- Department of Endocrinology, The Centre of Postgraduate Medical Education, Warsaw, Poland
| |
Collapse
|
7
|
Labadzhyan A, Nachtigall LB, Fleseriu M, Gordon MB, Molitch M, Kennedy L, Samson SL, Greenman Y, Biermasz N, Bolanowski M, Haviv A, Ludlam W, Patou G, Strasburger CJ. Oral octreotide capsules for the treatment of acromegaly: comparison of 2 phase 3 trial results. Pituitary 2021; 24:943-953. [PMID: 34173129 PMCID: PMC8550586 DOI: 10.1007/s11102-021-01163-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/11/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE Results are presented from 2 to 3 trials investigating oral octreotide capsules (OOC) as an alternative to injectable somatostatin receptor ligands (iSRLs) in the treatment of acromegaly. METHODS CH-ACM-01 was an open-label trial (N = 155) and CHIASMA OPTIMAL was a double-blind placebo-controlled (DPC) trial (N = 56), both investigating OOC as maintenance therapy for patients with acromegaly who were biochemical responders receiving iSRLs. RESULTS Baseline characteristics in both trials reflected those expected of patients with acromegaly responding to treatment and were similar between trials, despite differences in inclusion criteria. OOC demonstrated a consistent degree of biochemical response across trials, with 65% of patients in CH-ACM-01 maintaining response during the core period and 64% of patients in CHIASMA OPTIMAL at the end of the DPC. Mean insulin-like growth factor I (IGF-I) levels remained within inclusion criteria at the end of treatment in both trials. Of 110 patients entering the fixed-dose phase in CH-ACM-01, 80% maintained or improved acromegaly symptoms from baseline to the end of treatment. Over 85% of patients in both trials elected to continue into the extension phases. OOC were found to be well tolerated across both trials, and no dose-related adverse events were observed. CONCLUSIONS OOC demonstrated remarkably consistent results for biochemical response, durability of response, and preference to continue with oral treatment across these 2 complementary landmark phase 3 trials, despite differences in the design of each. Trial registration NCT03252353 (August 2017), NCT01412424 (August 2011).
Collapse
Affiliation(s)
| | - L B Nachtigall
- MGH Neuroendocrine and Pituitary Center, Chestnut Hill, MA, USA
| | - M Fleseriu
- Pituitary Center, Oregon Health & Sciences University, Portland, OR, USA
| | - M B Gordon
- Allegheny Neuroendocrinology Center, Allegheny General Hospital, Pittsburgh, PA, USA
| | - M Molitch
- Northwestern University, Chicago, IL, USA
| | - L Kennedy
- Cleveland Clinic Foundation, Cleveland, OH, USA
| | | | - Y Greenman
- Sourasky Medical Center and Tel Aviv University, Tel Aviv, Israel
| | - N Biermasz
- Leiden University Medical Center, Leiden, The Netherlands
| | | | - A Haviv
- Chiasma, Inc., Needham, MA, USA
| | - W Ludlam
- Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - G Patou
- Chiasma, Inc., Needham, MA, USA
| | | |
Collapse
|
8
|
Moncrieffe D, Cox HD, Carletta S, Becker JO, Thomas A, Eichner D, Ahrens B, Thevis M, Bowers LD, Cowan DA, Hoofnagle AN. Inter-Laboratory Agreement of Insulin-like Growth Factor 1 Concentrations Measured Intact by Mass Spectrometry. Clin Chem 2020; 66:579-586. [PMID: 32232452 DOI: 10.1093/clinchem/hvaa043] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 01/22/2020] [Indexed: 11/13/2022]
Abstract
BACKGROUND Insulin-like growth factor-I (IGF-1) is measured mainly by immunoassay for the diagnosis and treatment of growth hormone (GH) disorders, and to detect misuse of GH in sport. Immunoassays often have insufficient inter-laboratory agreement, especially between commercial kits. Over the expected range of IGF-1 in blood (∼50-500 ng/mL), in an inter-laboratory study we previously established a measurement imprecision of 11% (%CV) for the digested protein analyzed by LC-MS. Measuring intact IGF-1 by LC-MS should be simpler. However, no inter-laboratory agreement has been published. METHODS Intact and trypsin-digested IGF-1 in 32 serum samples from healthy volunteers and human growth hormone administration studies were analyzed by LC-MS using different instruments in five laboratories, as well as by immunoassay in a single laboratory. Another 100 samples were analyzed for IGF-1, both intact and after trypsin-digestion, in each laboratory by LC-MS. The statistical relationship between measurements and the imprecision of each assay group was assessed. RESULTS An intra-laboratory variability of 2-4% CV was obtained. Inter-laboratory variability was greater at 14.5% CV. Orthogonal regression of intact versus trypsin-digestion methods (n = 646) gave a slope of 1.01 and intercept of 2.05 ng/mL. CONCLUSIONS LC-MS measurements of IGF-1 by intact and trypsin-digestion methods are not statistically different and each is similar to immunoassay. The two LC-MS approaches may be used interchangeably or together to eliminate concerns regarding an immunoassay IGF-1 measurement. Because intact and digested IGF-1 measurements generally agreed within 20% of each other, we propose this as a criterion of assay acceptability.
Collapse
Affiliation(s)
- Danielle Moncrieffe
- Drug Control Centre, Department of Analytical, Environmental and Forensic Science, King's College London, London, UK.,Department of Analytical, Environmental and Forensic Sciences, King's College London, London, UK
| | - Holly D Cox
- Sports Medicine Research and Testing Laboratory, 560 Arapeen Dr., Suite 150A, Salt Lake City, UT 84108
| | - Samantha Carletta
- Olympic Analytical Laboratory Department of Pathology & Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Jessica O Becker
- Department of Laboratory Medicine, University of Washington, Seattle, WA
| | - Andreas Thomas
- Center for Preventive Doping Research (ZePräDo), Institute of Biochemistry, German Sport University, Cologne, Germany
| | - Daniel Eichner
- Sports Medicine Research and Testing Laboratory, 560 Arapeen Dr., Suite 150A, Salt Lake City, UT 84108
| | - Brian Ahrens
- Olympic Analytical Laboratory Department of Pathology & Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Mario Thevis
- Center for Preventive Doping Research (ZePräDo), Institute of Biochemistry, German Sport University, Cologne, Germany
| | | | - David A Cowan
- Department of Analytical, Environmental and Forensic Sciences, King's College London, London, UK
| | - Andrew N Hoofnagle
- Department of Laboratory Medicine, University of Washington, Seattle, WA
| |
Collapse
|
9
|
Cavalier E, Lukas P, Bottani M, Aarsand AK, Ceriotti F, Coşkun A, Díaz-Garzón J, Fernàndez-Calle P, Guerra E, Locatelli M, Sandberg S, Carobene A. European Biological Variation Study (EuBIVAS): within- and between-subject biological variation estimates of β-isomerized C-terminal telopeptide of type I collagen (β-CTX), N-terminal propeptide of type I collagen (PINP), osteocalcin, intact fibroblast growth factor 23 and uncarboxylated-unphosphorylated matrix-Gla protein-a cooperation between the EFLM Working Group on Biological Variation and the International Osteoporosis Foundation-International Federation of Clinical Chemistry Committee on Bone Metabolism. Osteoporos Int 2020; 31:1461-1470. [PMID: 32270253 DOI: 10.1007/s00198-020-05362-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/19/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED We have calculated the biological variation (BV) of different bone metabolism biomarkers on a large, well-described cohort of subjects. BV is important to calculate reference change value (or least significant change) which allows evaluating if the difference observed between two consecutive measurements in a patient is biologically significant or not. INTRODUCTION Within-subject (CVI) and between-subject (CVG) biological variation (BV) estimates are essential in determining both analytical performance specifications (APS) and reference change values (RCV). Previously published estimates of BV for bone metabolism biomarkers are generally not compliant with the most up-to-date quality criteria for BV studies. We calculated the BV and RCV for different bone metabolism markers, namely β-isomerized C-terminal telopeptide of type I collagen (β-CTX), N-terminal propeptide of type I collagen (PINP), osteocalcin (OC), intact fibroblast growth factor 23 (iFGF-23), and uncarboxylated-unphosphorylated Matrix-Gla Protein (uCuP-MGP) using samples from the European Biological Variation Study (EuBIVAS). METHODS In the EuBIVAS, 91 subjects were recruited from six European laboratories. Fasting blood samples were obtained weekly for ten consecutive weeks. The samples were run in duplicate on IDS iSYS or DiaSorin Liaison instruments. The results were subjected to outlier and variance homogeneity analysis before CV-ANOVA was used to obtain the BV estimates. RESULTS We found no effect of gender upon the CVI estimates. The following CVI estimates with 95% confidence intervals (95% CI) were obtained: β-CTX 15.1% (14.4-16.0%), PINP 8.8% (8.4-9.3%), OC 8.9% (8.5-9.4%), iFGF23 13.9% (13.2-14.7%), and uCuP-MGP 6.9% (6.1-7.3%). CONCLUSIONS The EuBIVAS has provided updated BV estimates for bone markers, including iFGF23, which have not been previously published, facilitating the improved follow-up of patients being treated for metabolic bone disease.
Collapse
Affiliation(s)
- E Cavalier
- Department of Clinical Chemistry, University of Liège, CHU de Liège, 4000, Liège, Belgium.
- International Federation of Clinical Chemistry-International Osteoporosis Foundation Committee for Bone Markers, Milan, Italy.
| | - P Lukas
- Department of Clinical Chemistry, University of Liège, CHU de Liège, 4000, Liège, Belgium
| | - M Bottani
- IRCCS Istituto Ortopedico Galeazzi, Laboratory of Experimental Biochemistry & Molecular Biology, Milan, Italy
| | - A K Aarsand
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
- Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
- Biological Variation Working Group, European Federation of Clinical Chemistry and Laboratory Medicine, Milan, Italy
| | - F Ceriotti
- Clinical Laboratory, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - A Coşkun
- Biological Variation Working Group, European Federation of Clinical Chemistry and Laboratory Medicine, Milan, Italy
- School of Medicine, Acibadem Mehmet Ali Aydinlar University, Atasehir, Istanbul, Turkey
| | - J Díaz-Garzón
- Biological Variation Working Group, European Federation of Clinical Chemistry and Laboratory Medicine, Milan, Italy
- Quality Analytical Commission of Spanish Society of Laboratory Medicine (SEQC-ML), Hospital Universitario La Paz, Madrid, Spain
| | - P Fernàndez-Calle
- Biological Variation Working Group, European Federation of Clinical Chemistry and Laboratory Medicine, Milan, Italy
- Quality Analytical Commission of Spanish Society of Laboratory Medicine (SEQC-ML), Hospital Universitario La Paz, Madrid, Spain
| | - E Guerra
- Laboratory Medicine, Ospedale San Raffaele, Milan, Italy
| | - M Locatelli
- Laboratory Medicine, Ospedale San Raffaele, Milan, Italy
| | - S Sandberg
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
- Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
- Biological Variation Working Group, European Federation of Clinical Chemistry and Laboratory Medicine, Milan, Italy
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - A Carobene
- Biological Variation Working Group, European Federation of Clinical Chemistry and Laboratory Medicine, Milan, Italy
- Laboratory Medicine, Ospedale San Raffaele, Milan, Italy
| | | |
Collapse
|
10
|
Wang S, Mu R, Zhang X, Yun K, Shang H, Zhao M. Biological variation in serum bone turnover markers. Ann Clin Biochem 2020; 57:144-150. [PMID: 31842583 DOI: 10.1177/0004563219899119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background Serum total N-terminal propeptide of type I collagen (P1NP) and serum C-terminal telopeptide of type I collagen (CTX) are used as reference analytes of bone turnover in clinical application. Biological variation is important for clinical application of these biomarkers. However, the biological variation data of these biomarkers are not consistent. The present study determined biological variations of total P1NP and CTX and their confidence intervals in China using electrochemiluminescence. Methods We collected samples from 25 healthy individuals (17 women and 8 men, ranging from 22 to 49 years of age) at weekly intervals for six weeks. Samples were analysed in a single run in duplicate. Biological variations and their related parameters, such as reference change value and index of individuality (II) were calculated. The results were compared with individual studies in the EFLM database. Results Within-subject and between-subject biological variations were 8.0% and 32.5% for total P1NP and 11.4% and 38.7% for CTX, respectively. The index of individuality for total P1NP and CTX was 0.25 and 0.30, while the reference change value for P1NP values and CTX was 22.4% and 31.9%, respectively. Conclusions No difference was found in weekly biological variation of bone turnover markers between men and premenopausal women. Compared with daily and monthly variation, the present study based on weekly variation provided additional support for clinical application.
Collapse
Affiliation(s)
- Shuo Wang
- Department of Laboratory Medicine, The First Hospital of China Medical University, Shenyang, China.,National Clinical Research Center for Laboratory Medicine, The First Hospital of China Medical University, Shenyang, China
| | - Runqing Mu
- Department of Laboratory Medicine, The First Hospital of China Medical University, Shenyang, China.,National Clinical Research Center for Laboratory Medicine, The First Hospital of China Medical University, Shenyang, China
| | - Xin Zhang
- Department of Laboratory Medicine, The First Hospital of China Medical University, Shenyang, China.,National Clinical Research Center for Laboratory Medicine, The First Hospital of China Medical University, Shenyang, China
| | - Ke Yun
- Department of Laboratory Medicine, The First Hospital of China Medical University, Shenyang, China.,National Clinical Research Center for Laboratory Medicine, The First Hospital of China Medical University, Shenyang, China
| | - Hong Shang
- Department of Laboratory Medicine, The First Hospital of China Medical University, Shenyang, China.,National Clinical Research Center for Laboratory Medicine, The First Hospital of China Medical University, Shenyang, China
| | - Min Zhao
- Department of Laboratory Medicine, The First Hospital of China Medical University, Shenyang, China.,National Clinical Research Center for Laboratory Medicine, The First Hospital of China Medical University, Shenyang, China
| |
Collapse
|
11
|
Holt RIG, Ho KKY. The Use and Abuse of Growth Hormone in Sports. Endocr Rev 2019; 40:1163-1185. [PMID: 31180479 DOI: 10.1210/er.2018-00265] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 02/27/2019] [Indexed: 12/18/2022]
Abstract
GH is banned by the World Anti-Doping Agency as a performance-enhancing anabolic agent. Doping with GH likely began in the early 1980s and became more prevalent with the advent of recombinant technology well before any scientific evidence of benefit. The expectation that GH improves physical function stems from its anabolic and lipolytic properties. Athletic performance depends on muscle strength and the energy required to power muscle function. In recreational athletes, GH selectively improves anaerobic sprint capacity but has not been proven to significantly enhance muscle strength, power, or maximum rate of oxygen consumption. GH is secreted as a family of isoform peptides in a pulsatile manner reflecting intermittent secretion and rapid clearance. Its anabolic actions are largely mediated by IGF-I, which stimulates whole-body protein synthesis, including skeletal muscle and collagen proteins. Two methods have been validated for detecting GH abuse in athletes. The first (the isoform method) is based on distinguishing pure recombinant 22-kDa GH from the heterogeneous isoforms secreted from the pituitary. The second (the marker method) is based on measuring blood levels of GH-responsive proteins, specifically IGF-I and the N-terminal propeptide of type III collagen (P-III-NP). Only a handful of athletes have been caught since the implementation of GH doping tests in 2004. The low rate likely reflects the limitation of in-competition testing using current methods. Improved detection rates may be achieved by more out-of-competition testing, introducing athletes' biological passports, and the development of novel methods. Governance, operational, technical, and political factors influence the effectiveness of an anti-doping program.
Collapse
Affiliation(s)
- Richard I G Holt
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Ken K Y Ho
- Garvan Institute of Medical Research, St. Vincent's Hospital, University of New South Wales, Sydney, New South Wales, Australia
| |
Collapse
|
12
|
English K, Chikani V, Dimeski G, Inder WJ. Elevated insulin-like growth factor-1 in Cushing's disease. Clin Endocrinol (Oxf) 2019; 91:141-147. [PMID: 30901100 DOI: 10.1111/cen.13974] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 03/05/2019] [Accepted: 03/19/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine if patients with untreated Cushing's disease have higher serum insulin-like growth factor-1 (IGF-1) compared to matched controls, and if IGF-1 decreases following remission of Cushing's disease. DESIGN Retrospective case-control study matching Cushing's disease cases to control patients for adenoma size, age, sex, diabetic and gonadal status, body mass index and serum IGF-1 measured within one year. Paired analysis of pre-operative (untreated) and >3 months post-operative (remission) serum IGF-1 for cases. PATIENTS AND MEASUREMENTS All patients were investigated at the Princess Alexandra Hospital Endocrine Unit between 2005 and 2017. Serum IGF-1 was measured in 25 cases and 49 controls, 23 case-control pairs and 13 cases pre- and post-operatively. RESULTS Mean serum IGF-1 in cases was significantly higher compared to controls-32 ± 12 nmol/L compared to 25 ± 8 nmol/L, (P = 0.005). The proportion of cases with elevated serum IGF-1 above an age-adjusted reference range was higher compared to 1:1 matched controls (8/23 (35%) vs 1/23 (4%), P = 0.02). In 13 cases in remission post-operatively, serum IGF-1 decreased significantly from 31 (IQR 29-40.5) nmol/L to 23 (IQR 15-28.5) nmol/L, (P < 0.001), despite no difference in the prevalence of pre- vs post-operative pituitary hormone dysfunction (P = 0.47). CONCLUSION Patients with untreated Cushing's disease may have elevated IGF-1, which decreases following remission. Mildly elevated IGF-1 in Cushing's disease does not imply pathological growth hormone (GH) excess.
Collapse
Affiliation(s)
- Katherine English
- Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Viral Chikani
- Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Goce Dimeski
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
- Department of Chemical Pathology, Pathology Queensland, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Warrick J Inder
- Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
13
|
Granada ML. Biochemical following-up of treated acromegaly. Limitations of the current determinations of IGF-I and perspective. MINERVA ENDOCRINOL 2019; 44:143-158. [DOI: 10.23736/s0391-1977.18.02922-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
14
|
Johannsson G, Bidlingmaier M, Biller BMK, Boguszewski M, Casanueva FF, Chanson P, Clayton PE, Choong CS, Clemmons D, Dattani M, Frystyk J, Ho K, Hoffman AR, Horikawa R, Juul A, Kopchick JJ, Luo X, Neggers S, Netchine I, Olsson DS, Radovick S, Rosenfeld R, Ross RJ, Schilbach K, Solberg P, Strasburger C, Trainer P, Yuen KCJ, Wickstrom K, Jorgensen JOL. Growth Hormone Research Society perspective on biomarkers of GH action in children and adults. Endocr Connect 2018; 7:R126-R134. [PMID: 29483159 PMCID: PMC5868631 DOI: 10.1530/ec-18-0047] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 02/26/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The Growth Hormone Research Society (GRS) convened a Workshop in 2017 to evaluate clinical endpoints, surrogate endpoints and biomarkers during GH treatment of children and adults and in patients with acromegaly. PARTICIPANTS GRS invited 34 international experts including clinicians, basic scientists, a regulatory scientist and physicians from the pharmaceutical industry. EVIDENCE Current literature was reviewed and expert opinion was utilized to establish the state of the art and identify current gaps and unmet needs. CONSENSUS PROCESS Following plenary presentations, breakout groups discussed questions framed by the planning committee. The attendees re-convened after each breakout session to share the group reports. A writing team compiled the breakout session reports into a document that was subsequently discussed and revised by participants. This was edited further and circulated for final review after the meeting. Participants from pharmaceutical companies were not part of the writing process. CONCLUSIONS The clinical endpoint in paediatric GH treatment is adult height with height velocity as a surrogate endpoint. Increased life expectancy is the ideal but unfeasible clinical endpoint of GH treatment in adult GH-deficient patients (GHDA) and in patients with acromegaly. The pragmatic clinical endpoints in GHDA include normalization of body composition and quality of life, whereas symptom relief and reversal of comorbidities are used in acromegaly. Serum IGF-I is widely used as a biomarker, even though it correlates weakly with clinical endpoints in GH treatment, whereas in acromegaly, normalization of IGF-I may be related to improvement in mortality. There is an unmet need for novel biomarkers that capture the pleiotropic actions of GH in relation to GH treatment and in patients with acromegaly.
Collapse
Affiliation(s)
- Gudmundur Johannsson
- Department of Internal Medicine and Clinical NutritionSahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Martin Bidlingmaier
- Medizinische Klinik und Poliklinik IVKlinikum der Universität München, Munich, Germany
| | - Beverly M K Biller
- Neuroendocrine UnitMassachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Felipe F Casanueva
- Department of MedicineComplejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | | | - Peter E Clayton
- Developmental Biology & MedicineFaculty of Biology, Medicine & Health, University of Manchester, Manchester, UK
| | - Catherine S Choong
- Department of EndocrinologyPrincess Margaret Hospital & School of Medicine, University of Western Australia, Western Australia, Australia
| | - David Clemmons
- Department of MedicineUniversity of North Carolina, Chapel Hill, North Carolina, USA
| | - Mehul Dattani
- Great Ormond Street Institute of Child HealthLondon, UK
| | - Jan Frystyk
- Department of EndocrinologyOdense University Hospital, Odense, Denmark
| | - Ken Ho
- Princess Alexandra Hospital and University of QueenslandBrisbane, Australia
| | - Andrew R Hoffman
- Department of MedicineStanford University and VA Palo Health Care System, Palo Alto, California, USA
| | - Reiko Horikawa
- National Center for Child Health and DevelopmentTokyo, Japan
| | - Anders Juul
- Department of Growth and ReproductionRigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - John J Kopchick
- Edison Biotechnology Institute and Heritage College of Osteopathic MedicineOhio University, Athens, Ohio, USA
| | - Xiaoping Luo
- Department of PediatricsTongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Sebastian Neggers
- Section of EndocrinologyDepartment of Medicine, Pituitary Centre Rotterdam, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Irene Netchine
- Service d'Explorations Fonctionnelles EndocriniennesAP-HP, Hôpital Trousseau, Sorbonne Université, INSERM UMRs 938, Paris, France
| | - Daniel S Olsson
- Department of EndocrinologyInstitute of Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Sally Radovick
- Rutgers University-Robert Wood Johnson Medical SchoolNew Brunswick, New Jersey, USA
| | - Ron Rosenfeld
- Department of PediatricsOregon Health Science University, Portland, Oregon, USA
| | | | - Katharina Schilbach
- Medizinische Klinik und Poliklinik IVKlinikum der Universität München, Munich, Germany
| | - Paulo Solberg
- Universidade do Estado do Rio de JaneiroRio de Janeiro, Brazil
| | | | - Peter Trainer
- The Christie NHS Foundation TrustUniversity of Manchester, Manchester, UK
| | - Kevin C J Yuen
- Barrow Pituitary CenterBarrow Neurological Institute, Department of Neuroendocrinology, University of Arizona College of Medicine, Phoenix, Arizona, USA
| | | | | |
Collapse
|
15
|
Markkanen HM, Pekkarinen T, Hämäläinen E, Välimäki MJ, Alfthan H, Stenman UH. Gender has to be taken into account in diagnosing adult growth hormone deficiency by the GHRH plus arginine test. Growth Horm IGF Res 2017; 35:52-56. [PMID: 28755537 DOI: 10.1016/j.ghir.2017.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 06/29/2017] [Accepted: 07/11/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Data on the effect of gender on the interpretation of the GHRH plus arginine stimulation test (GHRH+ARG test) is controversial. We validated the GHRH+ARG stimulation test in control subjects and patients with organic or idiopathic pituitary disease and a suspicion of adult growth hormone deficiency (AGHD) using the Immulite 2000 XPi GH assay. DESIGN We studied 126 apparently healthy adults (median age 38.8years) and 34 patients with a suspicion of AGHD (median age 42.2years). Identification of AGHD with the GHRH+ARG test was investigated with commonly accepted BMI-related consensus cut-off limits for peak GH concentrations. Serum samples collected during the GHRH+ARG test were analysed for GH in 2014-2015. Serum IGF-1 concentrations were studied as a reference. RESULTS In 14 of 65 (22%) control males the GH peak value was below the BMI-related cut-off limits for GH sufficiency indicating a false diagnosis of AGHD. All control females had a normal GHRH+ARG response. Median peak GH response was significantly (p<0.001) higher in female (39.3μg/L) than in male controls (21μg/L). According to consensus cut-offs all but one young female patient had a deficient response compatible with a diagnosis of AGHD. CONCLUSIONS The GH response to stimulation by GHRH+ARG is gender-dependent, being lower in healthy males than in females. Gender should be considered when defining cut-off limits for peak GH concentrations in the GHRH+ARG test. The presently used BMI-related cut-off levels will lead to a significant misclassification of males as GH deficient.
Collapse
Affiliation(s)
| | - Tuula Pekkarinen
- HUS Abdominal Centre, Endocrinology, Helsinki University Hospital, Helsinki, Finland
| | - Esa Hämäläinen
- Helsinki University Central Hospital, HUSLAB, Helsinki, Finland; Department of Clinical Chemistry, Helsinki University Central Hospital, Helsinki, Finland
| | - Matti J Välimäki
- HUS Abdominal Centre, Endocrinology, Helsinki University Hospital, Helsinki, Finland
| | - Henrik Alfthan
- Helsinki University Central Hospital, HUSLAB, Helsinki, Finland
| | - Ulf-Håkan Stenman
- Department of Clinical Chemistry, Helsinki University Central Hospital, Helsinki, Finland
| |
Collapse
|
16
|
Prospective and Descriptive Study on Serum Androstenedione Concentration in Healthy Children from Birth until 18 Years of Age and Its Associated Factors. DISEASE MARKERS 2017; 2017:9238304. [PMID: 28592912 PMCID: PMC5448042 DOI: 10.1155/2017/9238304] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 03/14/2017] [Indexed: 11/25/2022]
Abstract
Introduction Androstenedione (A4) is an adrenal and gonadal steroid biomarker, useful in the assessment of children in whom steroidogenic disorders are suspected. The first key step in the evaluation of a diagnostic test resides on confident reference intervals (RI). The lack of updated A4-RI with current methods in pediatrics may mislead A4 results and limit its diagnosis accuracy. Aim To provide A4 reference ranges in healthy children. Methods Prospective, descriptive study. 283 children aged 4 days to 18 years were included. In children < 1 yr, A4 was measured directly in serum (NE-A4) and postorganic solvent extraction (E-A4) for the assessment of interfering steroids. The influence of chronological age (CA), gender, and Tanner stage (T) were investigated. Results In the neonatal period, E-A4 was significantly lower than NE-A4; boys had higher NE-A4; sexual dimorphism disappeared after extraction procedure. In children older than 4 months, A4 concentration remained low until the age of 5 years. Thereafter, A4 increased significantly in association with CA and T (r2 = 0.65; p < 0.001), obtaining the highest concentrations in children within pubertal ages without sexual dimorphism. Conclusion We recommend to perform solvent extraction in neonates and to take into account age and sexual development to properly interpret A4 results in childhood.
Collapse
|
17
|
Chanson P, Arnoux A, Mavromati M, Brailly-Tabard S, Massart C, Young J, Piketty ML, Souberbielle JC. Reference Values for IGF-I Serum Concentrations: Comparison of Six Immunoassays. J Clin Endocrinol Metab 2016; 101:3450-8. [PMID: 27167056 PMCID: PMC5054194 DOI: 10.1210/jc.2016-1257] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
CONTEXT Measurement of IGF-I is essential for diagnosis and management of patients with disorders affecting the somatotropic axis. However, even when IGF-I kit manufacturers follow recent consensus guidelines, different kits can give very different results for a given sample. OBJECTIVES We sought to establish normative data for six IGF-I assay kits based on a large random sample of the French general adult population. SUBJECTS AND METHODS In a cross-sectional multicenter cohort study, we measured IGF-I in 911 healthy adults (18-90 years) with six immunoassays (iSYS, LIAISON XL, IMMULITE, IGFI RIACT, Mediagnost ELISA, and Mediagnost RIA). Pairwise concordance between assays was assessed with Bland-Altman plots for both IGF-1 raw data and standard deviation scores (SDS), as well as with the percentage of observed agreement and the weighted Kappa coefficient for categorized IGF-I SDS. RESULTS Normative data included the range of values (2.5-97.5 percentiles) given by the six IGF-I assays according to age group and sex. A formula for SDS calculation is provided. Although the lower limits of the reference intervals of the six assays were similar, the upper limits varied markedly. Pairwise concordances were moderate to good (0.38-0.70). CONCLUSION Despite being obtained in the same healthy population, the reference intervals of the six commercial IGF-1 assay kits showed noteworthy differences. Agreement between methods was moderate to good.
Collapse
Affiliation(s)
- Philippe Chanson
- Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance (P.C., M.M., J.Y.), Unité de Recherche Clinique (A.A.), and Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie (S.B.T.), Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin-Bicêtre, F94275, France; Inserm 1185 (P.C., S.B.T., J.Y.), Fac Med Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, F-94276, France; and Laboratoire d'Hormonologie (C.M.), Centre Hospitalier Universitaire de Rennes, Centre d'Investigation Clinique Plurithématique, Inserm 1414, Hôpital Pontchaillou, Rennes, F29000, France; Service des Explorations Fonctionnelles (M-L.P., J.-C.S.), Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, F75015, France
| | - Armelle Arnoux
- Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance (P.C., M.M., J.Y.), Unité de Recherche Clinique (A.A.), and Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie (S.B.T.), Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin-Bicêtre, F94275, France; Inserm 1185 (P.C., S.B.T., J.Y.), Fac Med Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, F-94276, France; and Laboratoire d'Hormonologie (C.M.), Centre Hospitalier Universitaire de Rennes, Centre d'Investigation Clinique Plurithématique, Inserm 1414, Hôpital Pontchaillou, Rennes, F29000, France; Service des Explorations Fonctionnelles (M-L.P., J.-C.S.), Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, F75015, France
| | - Maria Mavromati
- Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance (P.C., M.M., J.Y.), Unité de Recherche Clinique (A.A.), and Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie (S.B.T.), Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin-Bicêtre, F94275, France; Inserm 1185 (P.C., S.B.T., J.Y.), Fac Med Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, F-94276, France; and Laboratoire d'Hormonologie (C.M.), Centre Hospitalier Universitaire de Rennes, Centre d'Investigation Clinique Plurithématique, Inserm 1414, Hôpital Pontchaillou, Rennes, F29000, France; Service des Explorations Fonctionnelles (M-L.P., J.-C.S.), Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, F75015, France
| | - Sylvie Brailly-Tabard
- Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance (P.C., M.M., J.Y.), Unité de Recherche Clinique (A.A.), and Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie (S.B.T.), Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin-Bicêtre, F94275, France; Inserm 1185 (P.C., S.B.T., J.Y.), Fac Med Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, F-94276, France; and Laboratoire d'Hormonologie (C.M.), Centre Hospitalier Universitaire de Rennes, Centre d'Investigation Clinique Plurithématique, Inserm 1414, Hôpital Pontchaillou, Rennes, F29000, France; Service des Explorations Fonctionnelles (M-L.P., J.-C.S.), Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, F75015, France
| | - Catherine Massart
- Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance (P.C., M.M., J.Y.), Unité de Recherche Clinique (A.A.), and Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie (S.B.T.), Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin-Bicêtre, F94275, France; Inserm 1185 (P.C., S.B.T., J.Y.), Fac Med Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, F-94276, France; and Laboratoire d'Hormonologie (C.M.), Centre Hospitalier Universitaire de Rennes, Centre d'Investigation Clinique Plurithématique, Inserm 1414, Hôpital Pontchaillou, Rennes, F29000, France; Service des Explorations Fonctionnelles (M-L.P., J.-C.S.), Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, F75015, France
| | - Jacques Young
- Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance (P.C., M.M., J.Y.), Unité de Recherche Clinique (A.A.), and Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie (S.B.T.), Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin-Bicêtre, F94275, France; Inserm 1185 (P.C., S.B.T., J.Y.), Fac Med Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, F-94276, France; and Laboratoire d'Hormonologie (C.M.), Centre Hospitalier Universitaire de Rennes, Centre d'Investigation Clinique Plurithématique, Inserm 1414, Hôpital Pontchaillou, Rennes, F29000, France; Service des Explorations Fonctionnelles (M-L.P., J.-C.S.), Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, F75015, France
| | - Marie-Liesse Piketty
- Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance (P.C., M.M., J.Y.), Unité de Recherche Clinique (A.A.), and Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie (S.B.T.), Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin-Bicêtre, F94275, France; Inserm 1185 (P.C., S.B.T., J.Y.), Fac Med Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, F-94276, France; and Laboratoire d'Hormonologie (C.M.), Centre Hospitalier Universitaire de Rennes, Centre d'Investigation Clinique Plurithématique, Inserm 1414, Hôpital Pontchaillou, Rennes, F29000, France; Service des Explorations Fonctionnelles (M-L.P., J.-C.S.), Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, F75015, France
| | - Jean-Claude Souberbielle
- Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance (P.C., M.M., J.Y.), Unité de Recherche Clinique (A.A.), and Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie (S.B.T.), Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Le Kremlin-Bicêtre, F94275, France; Inserm 1185 (P.C., S.B.T., J.Y.), Fac Med Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, F-94276, France; and Laboratoire d'Hormonologie (C.M.), Centre Hospitalier Universitaire de Rennes, Centre d'Investigation Clinique Plurithématique, Inserm 1414, Hôpital Pontchaillou, Rennes, F29000, France; Service des Explorations Fonctionnelles (M-L.P., J.-C.S.), Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, F75015, France
| | | |
Collapse
|
18
|
Drogan D, Schulze MB, Boeing H, Pischon T. Insulin-Like Growth Factor 1 and Insulin-Like Growth Factor-Binding Protein 3 in Relation to the Risk of Type 2 Diabetes Mellitus: Results From the EPIC-Potsdam Study. Am J Epidemiol 2016; 183:553-60. [PMID: 26880678 DOI: 10.1093/aje/kwv188] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 07/10/2015] [Indexed: 12/27/2022] Open
Abstract
Higher levels of insulin-like growth factor-binding protein 3 (IGFBP-3) might raise the risk of type 2 diabetes mellitus (T2DM) via binding of insulin-like growth factor 1 (IGF-1), an insulin-like hormone that is involved in glucose homeostasis. We investigated serum concentrations of IGF-1 and IGFBP-3 and their molar ratio in relation to T2DM incidence in a nested case-cohort study within the European Prospective Investigation Into Cancer and Nutrition-Potsdam Study. We included a randomly selected subcohort of persons without T2DM at the time of blood sampling (n = 2,269) and 776 individuals with incident T2DM identified between 1994 and 2005. For the highest quartile versus lowest, the multivariable-adjusted hazard rate ratios were 0.91 (95% confidence interval (CI): 0.68, 1.23; P for trend = 0.31) for IGF-1, 1.33 (95% CI: 1.00, 1.76; P for trend = 0.04) for IGFBP-3, and 0.77 (95% CI: 0.57, 1.03; P for trend = 0.03) for IGF-1:IGFBP-3 ratio. IGFBP-3 level remained positively associated with T2DM incidence-and the ratio of IGF-1 to IGFBP-3 was inversely related with T2DM incidence--in models that included adjustment for IGF-1 concentrations (P for trend < 0.05). Therefore, our findings do not confirm an association between total IGF-1 concentrations and risk of T2DM in the general study population, although higher IGFBP-3 levels might raise T2DM risk independent of IGF-1 levels.
Collapse
|
19
|
Development and characterization of an enzyme-linked DNA aptamer-magnetic bead-based assay for human IGF-I in serum. Microchem J 2016. [DOI: 10.1016/j.microc.2015.08.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
20
|
Giannopoulou C, Cionca N, Almaghlouth A, Cancela J, Courvoisier DS, Mombelli A. Systemic Biomarkers in 2-Phase Antibiotic Periodontal Treatment: A Randomized Clinical Trial. J Dent Res 2015; 95:349-55. [PMID: 26604272 DOI: 10.1177/0022034515618949] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Accumulating evidence suggests that periodontal infections may have an impact on systemic health. In patients with untreated periodontitis, very high values for several inflammatory markers in serum are expressed simultaneously. We investigated to what extent these peak values change after nonsurgical and surgical periodontal treatment, with adjunctive antibiotics administered during the first or the second treatment phase. In a single-center, randomized, placebo-controlled, and double-masked clinical trial, 80 patients with chronic or aggressive periodontitis were randomized into 2 treatment groups: group A, receiving systemic amoxicillin and metronidazole during the first, nonsurgical phase of periodontal therapy (phase 1), and group B, receiving the antibiotics during the second, surgical phase (phase 2). Serum samples were obtained at baseline (BL), 3 mo after phase 1 (M3), and 6 and 12 mo after phase 2 (M6, M12). Samples were evaluated for 15 cytokines and 9 acute-phase proteins using the Bio-Plex bead array multianalyte detection system. For each analyte, peak values were defined as greater than mean +2 SD of measurements found in 40 periodontally healthy persons. Sixty-six patients showed a peak value of at least 1 analyte at BL. At M12, the number of these patients was only 36 (P = 0.0002). This decrease was stronger in group A (BL: 35, M12: 19, P = 0.0009) than in group B (BL: 31, M12: 17, P = 0.14). Twenty patients displayed peak values of at least 4 biomarkers at BL. The nonsurgical therapy delivered in the first phase reduced most of these peaks (group A, BL: 9, M3: 4, P = 0.17; group B, BL: 11, M3: 2, P = 0.01), irrespective of adjunctive antibiotics. The reductions obtained at M3 were maintained until M12 in both groups. Initial, nonsurgical periodontal therapy reduced the incidence of peak levels of inflammatory markers. Antibiotics and further surgical therapy did not enhance the effect (Clinicaltrials.gov NCT02197260).
Collapse
Affiliation(s)
- C Giannopoulou
- Division of Periodontology, School of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - N Cionca
- Division of Periodontology, School of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - A Almaghlouth
- Department of Dentistry, King Fahad Medical City, Riyadh, Saudi Arabia
| | - J Cancela
- Division of Periodontology, School of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - D S Courvoisier
- Center for Clinical Research and Division of Clinical Epidemiology, University of Geneva, Geneva, Switzerland
| | - A Mombelli
- Division of Periodontology, School of Dental Medicine, University of Geneva, Geneva, Switzerland
| |
Collapse
|
21
|
Fougère B, Vellas B, van Kan GA, Cesari M. Identification of biological markers for better characterization of older subjects with physical frailty and sarcopenia. Transl Neurosci 2015; 6:103-110. [PMID: 28123793 PMCID: PMC4936618 DOI: 10.1515/tnsci-2015-0009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 01/28/2015] [Indexed: 12/16/2022] Open
Abstract
Population aging is rapidly accelerating worldwide; however, longer life expectancy is not the only public health goal. Indeed, extended lifetime involves maintaining function and the capacity of living independently. Sarcopenia and physical frailty are both highly relevant entities with regards to functionality and autonomy of older adults. The concepts and definitions of frailty and sarcopenia have largely been revised over the years. Sarcopenia is an age-related progressive and generalized loss of skeletal muscle mass and strength. On the other hand, frailty is a state of increased vulnerability to stressors, responsible for exposing the older person to enhanced risk of adverse outcomes. Physical frailty and sarcopenia substantially overlap and several adverse outcomes of frailty are likely mediated by sarcopenia. Indeed, the concepts of sarcopenia and physical frailty can be perceived as related to the same target organ (i.e., skeletal muscle) and it may be possible to combine them into a unique definition. The biological background of such a close relationship needs to be explored and clarified as it can potentially provide novel and pivotal insights for the assessment and treatment of these conditions in old age. The aim of this paper is to indicate and discuss possible biological markers to be considered in the framing of physical frailty and sarcopenia.
Collapse
Affiliation(s)
- Bertrand Fougère
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Inserm UMR1027, Université de Toulouse III Paul Sabatier, Toulouse, France
| | - Bruno Vellas
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Inserm UMR1027, Université de Toulouse III Paul Sabatier, Toulouse, France
| | - Gabor Abellan van Kan
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Inserm UMR1027, Université de Toulouse III Paul Sabatier, Toulouse, France
| | - Matteo Cesari
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Inserm UMR1027, Université de Toulouse III Paul Sabatier, Toulouse, France
| |
Collapse
|
22
|
Junnila RK, Strasburger CJ, Bidlingmaier M. Pitfalls of insulin-like growth factor-i and growth hormone assays. Endocrinol Metab Clin North Am 2015; 44:27-34. [PMID: 25732639 DOI: 10.1016/j.ecl.2014.10.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Accurate measurement of growth hormone (GH) and insulin-like growth factor-I (IGF-I) are the key to correct diagnosis of acromegaly and GH deficiency. Unfortunately, there is much variation involved when these hormones are measured at different sites and using different assay methods. There is an ongoing global effort to standardize the measurement process to obtain more comparable results in the future. This review discusses common pitfalls in the measurement of GH and IGF-I and guides laboratories in their analyses of these hormones.
Collapse
Affiliation(s)
- Riia K Junnila
- Endocrine Research Unit, Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität (LMU), Ziemssenstr. 1, Munich 80336, Germany
| | - Christian J Strasburger
- Department of Endocrinology and Metabolic Diseases, Campus Charité Mitte, Charité Universitaetsmedizin, Charitéplatz 1, Berlin 10117, Germany
| | - Martin Bidlingmaier
- Endocrine Research Unit, Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität (LMU), Ziemssenstr. 1, Munich 80336, Germany.
| |
Collapse
|
23
|
Ballerini MG, Chiesa A, Morelli C, Frusti M, Ropelato MG. Serum concentration of 17α-hydroxyprogesterone in children from birth to adolescence. Horm Res Paediatr 2015; 81:118-25. [PMID: 24401679 DOI: 10.1159/000356906] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 10/03/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Reference intervals (RI) of serum 17α- hydroxyprogesterone (17OHP) are useful to confirm congenital adrenal hyperplasia (CAH) in neonates with abnormal screening results and nonclassical forms of CAH in symptomatic children. We aimed to establish serum 17OHP RI in normal children and adolescents using a current 17OHP radioimmunoassay (RIA). METHODS Serum 17OHP was measured via a current RIA (Diasource) in children, i.e. 111 infants aged <1 year [before (NE-17OHP) and after extraction (E-17OHP)] and 216 children aged 1-17 years. Forty NE serum samples from subjects aged >1 year, covering the whole analytical range, were simultaneously measured to compare 17OHP RIA from Diagnostic System Laboratories (DSL) (withdrawn) and Diasource by Passing Bablok linear regression and ratio plot. The equation obtained was used to correct our own previous RI (DSL RIA) for infancy for the Diasource RIA. Samples from infants aged <1 year were used to verify the calculated RI with evaluator protocol C28-A3. The influence of age, gender, and Tanner's classification (T) was assessed in children aged >1 year by ANOVA. RESULTS E-17OHP as measured via the Diasource RIA was significantly lower than NE-17OHP in infants aged <1 year (p < 0.0001). The 17OHP measurement from the Diasource RIA was negatively biased compared to the value obtained using the DSL RIA (Diasource (ng/ml) = 0.85 DSL (ng/ml) -0.32 ng/ml, r = 0.952). Most infants (93%) had age- and gender-adjusted NE-17OHP and E-17OHP levels within the recalculated RI. Serum 17OHP significantly increased throughout prepuberty (p < 0.001). Sexual dimorphism was only observed at T IV-V. CONCLUSION When evaluating 17OHP during childhood, we recommend taking into account the extraction procedure in neonates, the method used, age, and the Tanner's stage.
Collapse
Affiliation(s)
- María Gabriela Ballerini
- Centro de Investigaciones Endocrinológicas Dr. César Bergadá (CEDIE), CONICET - FEI, División de Endocrinología, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina
| | | | | | | | | |
Collapse
|
24
|
Safdar Z, Tamez E, Frost A, Guffey D, Minard CG, Entman ML. Collagen Metabolism Biomarkers and Health Related Quality of Life in Pulmonary Arterial Hypertension. ACTA ACUST UNITED AC 2015; 4. [PMID: 26366423 DOI: 10.4172/2324-8602.1000198] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The goal of this study was to investigate the association between collagen metabolism biomarkers and health related quality of life (HRQoL) in PAH patients. METHODS We prospectively enrolled 68 stable idiopathic, anorexigen-associated, and hereditary PAH subjects and 37 healthy controls. Serum samples were analyzed for N-terminal propeptide of type III procollagen (PIIINP), c-terminal telopeptide of collagen type I (CITP), matrix metalloproteinase 9 (MMP-9) and tissue inhibitor of metalloproteinase 1 (TIMP-1). The Minnesota Living with Heart Failure (MLWHF), Euro QoL-5D (EQ-5D), Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) and Short Form (SF-36) general health survey were administered at the time of blood draw. General linear models, as well as logistic regression models were used to assess associations between variables. RESULTS CITP, PIIINP, MMP9, and TIMP1 levels, and all HRQoL domains were significantly different between controls and PAH patients (p<0.001 for each). Interestingly, PIIINP levels were significantly associated with MLWHF physical (coef=1.63, and p=0.02), SF-36 physical (coef=-2.93, p=0.004), and EQ-5D aggregate (coef=0.34, p=0.001) scores. Several of the CAMPHOR scores strongly linearly associated with PIIINP. The odds of obtaining a walk distance ≥330 meters decrease by 38% per unit increase in PIIINP (OR=0.62; 95% CI=0.43, 0.90) and a PIIINP cutoff of 5.53 μg/L provided 81% sensitivity and 82% specificity. CONCLUSIONS PIIINP is a good predictor of disease severity, and is strongly related to HRQoL scores in PAH patients. These relationships suggest PIIINP as a promising tool for PAH clinicians to determine or confirm the level of disease severity.
Collapse
Affiliation(s)
- Zeenat Safdar
- Division of Pulmonary, Critical Care, and Sleep Medicine, Baylor College of Medicine, USA
| | - Emilio Tamez
- Division of Pulmonary, Critical Care, and Sleep Medicine, Baylor College of Medicine, USA
| | - Adaani Frost
- Division of Pulmonary, Critical Care, and Sleep Medicine, Baylor College of Medicine, USA
| | - Danielle Guffey
- Dan L Duncan Institute for Clinical and Translational Research, Baylor College of Medicine, USA
| | - Charles G Minard
- Dan L Duncan Institute for Clinical and Translational Research, Baylor College of Medicine, USA
| | - Mark L Entman
- Division of Cardiology, Baylor College of Medicine, USA
| |
Collapse
|
25
|
Abstract
The synthesis rates of fibrillar collagens can be assessed in blood by measuring propeptides set free from corresponding procollagens before fiber formation. Type I collagen is the major component of the organic matrix of bone, but it is also found in other connective tissues. The serum concentration of the amino-terminal propeptide of type I procollagen, PINP, functions as a measure of type I collagen synthesis during normal bone turnover, but it is also released from bone metastases that involve an osteoblastic component. Type III collagen is a major constituent of soft tissues and the corresponding amino-terminal propeptide, PIIINP, reflects collagen synthesis. Circulating PIIINP tends to be affected by malignomas that grow in the peritoneal cavity or affect bone marrow. Many studies on procollagen markers in cancer have been cross-sectional or demonstrated treatment effects in patient groups. Markers that originate from bone turnover have wide reference intervals, but low biologic variability in individuals. Thus, they appear better suited for monitoring versus diagnostic purposes. There is still definite need for research on the use of procollagen markers in the followup of individual patients undergoing cancer treatment or being monitored after such treatment.
Collapse
|
26
|
Ballerini MG, Domené HM, Scaglia P, Martínez A, Keselman A, Jasper HG, Ropelato MG. Association of serum components of the GH-IGFs-IGFBPs system with GHR-exon 3 polymorphism in normal and idiopathic short stature children. Growth Horm IGF Res 2013; 23:229-236. [PMID: 23999134 DOI: 10.1016/j.ghir.2013.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 07/30/2013] [Accepted: 08/13/2013] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To investigate the possible association of circulating components of GH-IGFs-IGFBPs system with the GHR-exon 3 genotype in normal and idiopathic short stature (ISS) children. DESIGN Descriptive, cross-sectional study in normal and ISS children. SUBJECTS AND METHODS 192 normal and 81 ISS children (age: 5-17 years) were included. Serum IGF-I, IGFBP3, ALS and GHBP levels were measured. GHR-exon 3 polymorphism (GHRd3) was analyzed by multiplex PCR assay. Normal and ISS children were divided according to GHR-exon 3 genotype: homozygous for the full-length GHR isoform (GHRfl) and carriers of one or two copies of the GHRd3 allele. RESULTS GHRd3 genotype distribution (fl:fl/fl:d3/d3:d3,%) in normal (60:34:6) and ISS (64:32:4) was similar and reached Hardy-Weinberg equilibrium. ISS children had significantly reduced levels of GHBP and GH-dependent factors as compared to controls (p<0.0001). Within the normal group, homozygous carriers of the GHRfl allele had significantly higher GHBP serum levels than those with one or two copies of the GHRd3 allele (Mean ± SEM; GHRfl: 3.2 ± 0.2 vs GHRd3: 2.7 ± 0.2 nmol/L, p = 0.04). No other significant association with GHR exon 3 polymorphism was found in either the normal or the ISS groups. CONCLUSIONS GHR exon 3 polymorphism is distributed similarly in normal and ISS children, however only normal homozygous children for GHRfl allele showed higher GHBP levels. The lack of association between GHBP and GHR polymorphism in ISS children might be related to the heterogeneity of this group, where potential defects in GH receptor action may result in partial GH insensitivity.
Collapse
Affiliation(s)
- María Gabriela Ballerini
- División de Endocrinología, Centro de Investigaciones Endocrinológicas (CEDIE-CONICET), Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina.
| | | | | | | | | | | | | |
Collapse
|
27
|
Kniess A, Ziegler E, Thieme D, Müller RK. Intra-individual variation of GH-dependent markers in athletes: Comparison of population based and individual thresholds for detection of GH abuse in sports. J Pharm Biomed Anal 2013; 84:201-8. [DOI: 10.1016/j.jpba.2013.06.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 06/10/2013] [Accepted: 06/12/2013] [Indexed: 11/25/2022]
|
28
|
Guha N, Cowan DA, Sönksen PH, Holt RIG. Insulin-like growth factor-I (IGF-I) misuse in athletes and potential methods for detection. Anal Bioanal Chem 2013; 405:9669-83. [DOI: 10.1007/s00216-013-7229-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 07/02/2013] [Accepted: 07/08/2013] [Indexed: 11/30/2022]
|
29
|
Gatti R, De Palo EF, Antonelli G, Spinella P. IGF-I/IGFBP system: metabolism outline and physical exercise. J Endocrinol Invest 2012; 35:699-707. [PMID: 22714057 DOI: 10.3275/8456] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The GH/IGF-I system plays a well-known hormonal role and its effects, mainly anabolic and insulin-sensitizing, are mediated through endocrine as well as paracrine/ autocrine mechanisms. This system includes the binding proteins, namely GH binding proteins and IGF-I binding proteins (IGFBP). As expected, this axis plays a key role in organism modification in consequence of a physical exercise. Physical activity, training, and exercise capacity chiefly involve anabolism process modifications of various tissues, in particular muscular adjustments. Numerous investigators found a correlation among the level of exercise tolerance, muscle strength or walking speed and IGF-I/IGFBP-3 concentrations. However, also inverse and absent correlations between circulating IGF-I concentrations and acute or chronic exercise responses have been reported. IGF-I is generally accepted as an important GH mediator with metabolic effects, through both endocrine and paracrine or autocrine mechanisms. GH is the main regulator of the hepatic synthesis of IGF-I and IGFBP-3, which is the most abundant IGF carrier in human plasma. Recently, it has been shown that the physical exercise stimulatory impact on skeletal muscles is mediated through an increased local IGF-I synthesis with an IGFPB involvement. An absent association of exercise performance and circulating IGF-I may indicate that exercise will exert muscle strength by predominately locally derived paracrine or autocrine mediators rather than endocrine circulating IGF-I. The present review considers the general aspects of the IGF/IGFPB system and the role of the IGF/IGFPB system in relation to physical exercise (type, duration, etc.) taking into account the training aspects.
Collapse
Affiliation(s)
- R Gatti
- Clinical Biochemistry, Department of Medical Diagnostic Sciences and Special Therapies, University of Padua, Padua, Italy
| | | | | | | |
Collapse
|
30
|
Abstract
GH is believed to be widely employed in sports as a performance-enhancing substance. Its use in athletic competition is banned by the World Anti-Doping Agency, and athletes are required to submit to testing for GH exposure. Detection of GH doping is challenging for several reasons including identity/similarity of exogenous to endogenous GH, short half-life, complex and fluctuating secretory dynamics of GH, and a very low urinary excretion rate. The detection test currently in use (GH isoform test) exploits the difference between recombinant GH (pure 22K-GH) and the heterogeneous nature of endogenous GH (several isoforms). Its main limitation is the short window of opportunity for detection (~12-24 h after the last GH dose). A second test to be implemented soon (the biomarker test) is based on stimulation of IGF-I and collagen III synthesis by GH. It has a longer window of opportunity (1-2 wk) but is less specific and presents a variety of technical challenges. GH doping in a larger sense also includes doping with GH secretagogues and IGF-I and its analogs. The scientific evidence for the ergogenicity of GH is weak, a fact that is not widely appreciated in athletic circles or by the general public. Also insufficiently appreciated is the risk of serious health consequences associated with high-dose, prolonged GH use. This review discusses the GH biology relevant to GH doping; the virtues and limitations of detection tests in blood, urine, and saliva; secretagogue efficacy; IGF-I doping; and information about the effectiveness of GH as a performance-enhancing agent.
Collapse
Affiliation(s)
- Gerhard P Baumann
- Partnership for Clean Competition, Colorado Springs, Colorado 80919, USA.
| |
Collapse
|
31
|
Abstract
PURPOSE OF REVIEW The diagnosis of growth hormone deficiency (GHD) in childhood is challenging, in large part because of the lack of a true gold standard and the relatively poor performance of available diagnostic testing. This review discusses the recent literature on this topic. RECENT FINDINGS Auxology and clinical judgment remain the foundation for the diagnosis of GHD. Provocative growth hormone testing is poorly reproducible, dependent on factors such as body composition and pubertal status, and further limited by significant variability among commercially available growth hormone assays. Measurement of insulin-like growth factor I and insulin-like growth factor-binding protein 3 is not diagnostically useful in isolation but is helpful in combination with other diagnostic measures. Neuroimaging is also useful to inform diagnosis, as pituitary abnormalities suggest a higher likelihood of GHD persisting into adulthood. Although genetic testing is not routinely performed in the diagnosis of GHD at the present time, multiple recent reports raise the possibility that it may play a more important role in diagnosing GHD in the future. SUMMARY Beyond physicians' integrated assessment of auxology, clinical presentation, and bone age, current tools to diagnose GHD are suboptimal. Recent literature emphasizes the need to reappraise our current practice and to consider new tools for diagnosis.
Collapse
Affiliation(s)
- Takara Stanley
- Pediatric Endocrine Unit, Program in Nutritional Metabolism, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
| |
Collapse
|
32
|
Jing J, Yang S, Zhou X, He C, Zhang L, Xu Y, Xie M, Yan Y, Su H, Wu M. Detection of doping with rhGH: Excretion study with WADA-approved kits. Drug Test Anal 2011; 3:784-90. [DOI: 10.1002/dta.359] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Revised: 08/16/2011] [Accepted: 08/17/2011] [Indexed: 11/08/2022]
|
33
|
Ding J, Okada S, Jørgensen JOL, Kopchick JJ. Novel serum protein biomarkers indicative of growth hormone doping in healthy human subjects. Proteomics 2011; 11:3565-71. [PMID: 21751372 DOI: 10.1002/pmic.201100077] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Revised: 05/03/2011] [Accepted: 06/08/2011] [Indexed: 11/06/2022]
Abstract
The detection of recombinant human growth hormone (rhGH) is difficult due to its short half-life; therefore, novel and robust biomarkers of rhGH abuse are needed. In this study, serum samples derived from subjects treated with rhGH in a randomized, double blind, placebo-controlled crossover study were analyzed by 2-DE coupled with MS. Eight healthy male subjects aged 23.2±0.6 years were injected with rhGH (2 mg/day) or saline for 7 days with serum samples drawn at days 0, 3, and 8. Protein intensities were quantified and analyzed for differences between rhGH and placebo treatments. Proteins that showed significant changes were identified and confirmed by Western blotting. These included specific isoforms of α-1 antitrypsin and transthyretin that increased; and inter-α-trypsin inhibitor heavy chain H4, apolipoprotein A-1, and hemoglobin β chain that decreased. These proteins represent novel biomarkers of short-term rhGH exposure and may lead to a new method for detecting rhGH doping.
Collapse
Affiliation(s)
- Juan Ding
- Edison Biotechnology Institute, Ohio University, Athens, OH 45701, USA
| | | | | | | |
Collapse
|
34
|
Detecting growth hormone abuse in athletes. Anal Bioanal Chem 2011; 401:449-62. [DOI: 10.1007/s00216-011-5068-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 03/25/2011] [Accepted: 04/25/2011] [Indexed: 01/21/2023]
|
35
|
Banfi G, Lombardi G, Colombini A, Lippi G. A world apart. Clin Chim Acta 2010; 411:1003-8. [DOI: 10.1016/j.cca.2010.03.039] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Revised: 03/24/2010] [Accepted: 03/27/2010] [Indexed: 01/28/2023]
|
36
|
Erotokritou-Mulligan I, Eryl Bassett E, Cowan DA, Bartlett C, Milward P, Sartorio A, Sönksen PH, Holt RIG. The use of growth hormone (GH)-dependent markers in the detection of GH abuse in sport: Physiological intra-individual variation of IGF-I, type 3 pro-collagen (P-III-P) and the GH-2000 detection score. Clin Endocrinol (Oxf) 2010; 72:520-6. [PMID: 19650783 DOI: 10.1111/j.1365-2265.2009.03668.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Growth Hormone is abused by athletes for its lipolytic and anabolic properties. Its use is prohibited by the World Anti-Doping Agency. The GH-2000 project developed a methodology to detect its abuse using the concentrations of two GH-dependent biomarkers, IGF-I and type 3 procollagen (P-III-P). The sensitivity of this method may be improved by considering intra-individual variability. AIM The aim of this study was to examine the intra-individual variability of IGF-I, P-III-P and the GH-2000 score. SUBJECTS AND METHODS IGF-I, P-III-P and GH-2000 score were evaluated in four longitudinal studies involving 303 elite and 78 amateur athletes. Samples were collected over a period of up to 12 months from a total of 238 men and 143 women aged between 17 and 53 years (mean 24.2). RESULTS The four studies showed good agreement with no apparent difference in within-individual variation between amateur and elite athletes. The intra-individual variability for IGF-I ranged between 14-16% while the variability for P-III-P was 7-18%. No athlete tested positive for growth hormone during any of the studies. The overall mean intra-individual variability of the GH-2000 score was less than 0.6 units in all studies. CONCLUSIONS The high stability of marker levels suggests that concentrations are largely genetically determined. Adopting a test based on the concept of an athlete's 'passport' or 'profiling' would take advantage of this and most likely increase the sensitivity of the test. These data also provide strong evidence that a positive test result for GH abuse would not occur as a result of chance variability.
Collapse
Affiliation(s)
- Ioulietta Erotokritou-Mulligan
- Endocrinology and Metabolism Sub-division, Developmental Origins of Health and Disease Division, School of Medicine, University of Southampton, Southampton, UK
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Abstract
Catching athletes abusing human growth hormone (GH) by official antidoping tests is challenging because of specific properties of the hormone. Furthermore, the chemical structure of recombinant GH (rGH) is identical to that of the main GH isoform secreted by the pituitary, making it difficult to discriminate between endogenous and injected GH molecules by biochemical tests. The approaches developed to solve the problem include the "marker approach," which measures changes in concentration of GH-dependent proteins that are inappropriately elevated after rGH injection, and the "isoform approach," which detects changes in the spectrum of circulating GH isoforms after administration of rGH. A more widespread use of these tests in out-of-competition controls will enhance the likelihood to detect GH doping.
Collapse
Affiliation(s)
- Martin Bidlingmaier
- Endocrine Research Laboratories, Medizinische Klinik-Innenstadt, Ludwig-Maximilians University, Munich, Germany.
| | | |
Collapse
|
38
|
Frystyk J, Freda P, Clemmons DR. The current status of IGF-I assays--a 2009 update. Growth Horm IGF Res 2010; 20:8-18. [PMID: 19818658 PMCID: PMC7748085 DOI: 10.1016/j.ghir.2009.09.004] [Citation(s) in RCA: 114] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2009] [Accepted: 09/16/2009] [Indexed: 10/20/2022]
Abstract
For almost three decades, the measurement of circulating IGF-I has constituted a highly important biochemical tool in the management of GH disorders. In fact, in acromegaly the importance of circulating IGF-I has increased following the introduction of the GH receptor antagonist pegvisomant, as the use of this drug makes it impossible to use circulating GH as a monitor of disease activity. In addition, determination of circulating IGF-I constitutes a valuable scientific tool in various research areas, from epidemiological investigations through clinical trials and experimental studies. The multiple facets of IGF-I physiology and patho-physiology may explain why numerous endocrine laboratories have invested in IGF-I assays, by means of either in-house assays or commercial kits. However, despite its widespread use, the measurement of IGF-I is by no means trivial. On the contrary, the pronounced binding of IGF-I to the high-affinity IGF-binding proteins (IGFBPs) constitutes a notorious source of error, which has necessitated the development of methods that more or less successfully circumvent interference from the IGFBPs. Furthermore, there are some unsolved issues with the international standardization of the different IGF-I assays and there is no consensus regarding the procedures used when collecting and storing samples for measurement of circulating IGF-I. The aim of this review is to discuss the current state of the art of IGF-I immunoassays and to present the current analytical problems with IGF-I measurements. Finally, we would like to suggest an agenda that may be used when trying to produce internationally accepted uniform requirements for future IGF-I assays.
Collapse
Affiliation(s)
- Jan Frystyk
- The Medical Research Laboratories, Clinical Institute of Medicine, and Medical Department M (Diabetes & Endocrinology), Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark.
| | | | | |
Collapse
|
39
|
Mitchell CJ, Nelson AE, Cowley MJ, Kaplan W, Stone G, Sutton SK, Lau A, Lee CMY, Ho KKY. Detection of growth hormone doping by gene expression profiling of peripheral blood. J Clin Endocrinol Metab 2009; 94:4703-9. [PMID: 19875482 DOI: 10.1210/jc.2009-1038] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
CONTEXT GH abuse is a significant problem in many sports, and there is currently no robust test that allows detection of doping beyond a short window after administration. OBJECTIVE Our objective was to evaluate gene expression profiling in peripheral blood leukocytes in-vivo as a test for GH doping in humans. DESIGN Seven men and thirteen women were administered GH, 2 mg/d sc for 8 wk. Blood was collected at baseline and at 8 wk. RNA was extracted from the white cell fraction. Microarray analysis was undertaken using Agilent 44K G4112F arrays using a two-color design. Quantitative RT-PCR using TaqMan gene expression assays was performed for validation of selected differentially expressed genes. RESULTS GH induced an approximately 2-fold increase in circulating IGF-I that was maintained throughout the 8 wk of the study. GH induced significant changes in gene expression with 353 in women and 41 in men detected with a false discovery rate of less than 5%. None of the differentially expressed genes were common between men and women. The maximal changes were a doubling for up-regulated or halving for down-regulated genes, similar in magnitude to the variation between individuals. Quantitative RT-PCR for seven target genes showed good concordance between microarray and quantitative PCR data in women but not in men. CONCLUSION Gene expression analysis of peripheral blood leukocytes is unlikely to be a viable approach for the detection of GH doping.
Collapse
Affiliation(s)
- Christopher J Mitchell
- Pituitary Research Unit, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst New South Wales 2010, Sydney, Australia
| | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Abstract
Dysregulated growth hormone (GH) hypersecretion is usually caused by a GH-secreting pituitary adenoma and leads to acromegaly - a disorder of disproportionate skeletal, tissue, and organ growth. High GH and IGF1 levels lead to comorbidities including arthritis, facial changes, prognathism, and glucose intolerance. If the condition is untreated, enhanced mortality due to cardiovascular, cerebrovascular, and pulmonary dysfunction is associated with a 30% decrease in life span. This Review discusses acromegaly pathogenesis and management options. The latter include surgery, radiation, and use of novel medications. Somatostatin receptor (SSTR) ligands inhibit GH release, control tumor growth, and attenuate peripheral GH action, while GH receptor antagonists block GH action and effectively lower IGF1 levels. Novel peptides, including SSTR ligands, exhibiting polyreceptor subtype affinities and chimeric dopaminergic-somatostatinergic properties are currently in clinical trials. Effective control of GH and IGF1 hypersecretion and ablation or stabilization of the pituitary tumor mass lead to improved comorbidities and lowering of mortality rates for this hormonal disorder.
Collapse
Affiliation(s)
- Shlomo Melmed
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.
| |
Collapse
|
41
|
Bhasin S, He EJ, Kawakubo M, Schroeder ET, Yarasheski K, Opiteck GJ, Reicin A, Chen F, Lam R, Tsou JA, Castaneda-Sceppa C, Binder EF, Azen SP, Sattler FR. N-terminal propeptide of type III procollagen as a biomarker of anabolic response to recombinant human GH and testosterone. J Clin Endocrinol Metab 2009; 94:4224-33. [PMID: 19837911 PMCID: PMC2775648 DOI: 10.1210/jc.2009-1434] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Biomarkers that predict musculoskeletal response to anabolic therapies should expedite drug development. During collagen synthesis in soft lean tissue, N-terminal propeptide of type III procollagen (P3NP) is released into circulation. We investigated P3NP as a biomarker of lean body mass (LBM) and muscle strength gains in response to testosterone and GH. DESIGN Community-dwelling older men received GnRH agonist plus 5 or 10 g testosterone gel plus 0, 3, or 5 microg recombinant human GH daily. P3NP levels were measured at baseline and wk 4, 8, 12, and 16. LBM and appendicular skeletal muscle mass (ASM) were measured by dual-energy x-ray absorptiometry. RESULTS One hundred twelve men completed treatment; 106 underwent serum P3NP measurements. P3NP levels were higher at wk 4 than baseline (6.61 +/- 2.14 vs. 4.51 +/- 1.05, P < 0.0001) and reached plateau by wk 4 in men receiving testosterone alone. However, wk 8 P3NP levels were higher than wk 4 levels in men receiving testosterone plus recombinant human GH. Increases in P3NP from baseline to wk 4 and 16 were significantly associated with gains in LBM (r = 0.26, P = 0.007; r = 0.53, P < 0.001) and ASM (r = 0.17, P = 0.07; r = 0.40, P < 0.0001). Importantly, for participants receiving only testosterone, P3NP increases at wk 4 and 16 were related to muscle strength gains (r = 0.20, P = 0.056 and r = 0.36, P = 0.04). In stepwise regression, change in P3NP explained 28 and 30% of the change in ASM and LBM, respectively, whereas change in testosterone but not IGF-I and age provided only small improvements in the models. CONCLUSION Early changes in serum P3NP levels are associated with subsequent changes in LBM and ASM during testosterone and GH administration. Serum P3NP may be a useful early predictive biomarker of anabolic response to GH and testosterone.
Collapse
Affiliation(s)
- Shalender Bhasin
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts 02118, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Abstract
The fight against doping in sport using analytical chemistry is a mature area with a history of approximately 100 years in horse racing and at least 40 years in human sport. Over that period, the techniques used and the breadth of coverage have developed significantly. These improvements in the testing methods have been matched by the increased sophistication of the methods, drugs and therapies available to the cheat and, as a result, testing has been a reactive process constantly adapting to meet new threats. Following the inception of the World Anti-Doping Agency, research into the methods and technologies available for human doping control have received coordinated funding on an international basis. The area of biomarker research has been a major beneficiary of this funding. The aim of this article is to review recent developments in the application of biomarkers to doping control and to assess the impact this could make in the future.
Collapse
|
43
|
Ding J, List EO, Okada S, Kopchick JJ. Perspective: proteomic approach to detect biomarkers of human growth hormone. Growth Horm IGF Res 2009; 19:399-407. [PMID: 19501004 PMCID: PMC2760539 DOI: 10.1016/j.ghir.2009.04.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/03/2009] [Indexed: 10/20/2022]
Abstract
Several serum biomarkers for recombinant human growth hormone (rhGH) have been established, however, none alone or in combination have generate a specific, sensitive, and reproducible 'kit' for the detection of rhGH abuse. Thus, the search for additional GH specific biomarkers continues. In this review, we focus on the use of proteomics in general and two-dimensional electrophoresis (2-DE) in particular for the discovery of new GH induced serum biomarkers. Also, we review some of the protocols involved in 2-DE. Finally, the possibility of tissues other than blood for biomarker discovery is discussed.
Collapse
Affiliation(s)
- Juan Ding
- Edison Biotechnology Institute, College of Osteopathic Medicine, Ohio University, Athens, Ohio 45701, USA
- Molecular and Cellular Biology Program, College of Osteopathic Medicine, Ohio University, Athens, Ohio 45701, USA
- Department of Biological Sciences, College of Osteopathic Medicine, Ohio University, Athens, Ohio 45701, USA
| | - Edward O. List
- Edison Biotechnology Institute, College of Osteopathic Medicine, Ohio University, Athens, Ohio 45701, USA
| | - Shigeru Okada
- Edison Biotechnology Institute, College of Osteopathic Medicine, Ohio University, Athens, Ohio 45701, USA
- Department of Biomedical Sciences, College of Osteopathic Medicine, Ohio University, Athens, Ohio 45701, USA
| | - John J. Kopchick
- Edison Biotechnology Institute, College of Osteopathic Medicine, Ohio University, Athens, Ohio 45701, USA
- Molecular and Cellular Biology Program, College of Osteopathic Medicine, Ohio University, Athens, Ohio 45701, USA
- Department of Biomedical Sciences, College of Osteopathic Medicine, Ohio University, Athens, Ohio 45701, USA
| |
Collapse
|
44
|
Bidlingmaier M, Suhr J, Ernst A, Wu Z, Keller A, Strasburger CJ, Bergmann A. High-sensitivity chemiluminescence immunoassays for detection of growth hormone doping in sports. Clin Chem 2009; 55:445-53. [PMID: 19168559 DOI: 10.1373/clinchem.2008.112458] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Recombinant human growth hormone (rhGH) is abused in sports, but adequate routine doping tests are lacking. Analysis of serum hGH isoform composition has been shown to be effective in detecting rhGH doping. We developed and validated selective immunoassays for isoform analysis with potential utility for screening and confirmation in doping tests. METHODS Monoclonal antibodies with preference for pituitary hGH (phGH) or rhGH were used to establish 2 pairs of sandwich-type chemiluminescence assays with differential recognition of rhGH (recA and recB) and phGH (pitA and pitB). We analyzed specimens from volunteers before and after administration of rhGH and calculated ratios between the respective rec- and pit-assay results. RESULTS Functional sensitivities were <0.05 microg/L, with intra- and interassay imprecision < or =8.4% and < or =13.7%, respectively. In 2 independent cohorts of healthy subjects, rec/pit ratios (median range) were 0.84 (0.09-1.32)/0.81 (0.27-1.21) (recA/pitA) and 0.68 (0.08-1.20)/0.80 (0.25-1.36) (recB/pitB), with no sex difference. In 20 recreational athletes, ratios (median SD) increased after a single injection of rhGH, reaching 350% (73%) (recA/pitA) and 400% (93%) (recB/pitB) of baseline ratios. At a moderate dose (0.033 mg/kg), mean recA/pitA and recB/pitB ratios remained significantly increased for 18 h (men) and 26 h (women). After high-dose rhGH (0.083 mg/kg), mean rec/pit ratios remained increased for 32 h (recA/pitA) and 34 h (recB/pitB) in men and were still increased after 36 h in women. CONCLUSIONS Using sensitive chemiluminescence assays with preferential recognition of phGH or rhGH, detection of a single injection of rhGH was possible for up to 36 h.
Collapse
Affiliation(s)
- Martin Bidlingmaier
- Medizinische Klinik-Innenstadt, Ludwig-Maximilians-University, Munich, Germany.
| | | | | | | | | | | | | |
Collapse
|
45
|
Bowers LD. The analytical chemistry of drug monitoring in athletes. ANNUAL REVIEW OF ANALYTICAL CHEMISTRY (PALO ALTO, CALIF.) 2009; 2:485-507. [PMID: 20636072 DOI: 10.1146/annurev-anchem-060908-155159] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The detection and deterrence of the abuse of performance-enhancing drugs in sport are important to maintaining a level playing field among athletes and to decreasing the risk to athletes' health. The World Anti-Doping Program consists of six documents, three of which play a role in analytical development: The World Anti-Doping Code, The List of Prohibited Substances and Methods, and The International Standard for Laboratories. Among the classes of prohibited substances, three have given rise to the most recent analytical developments in the field: anabolic agents; peptide and protein hormones; and methods to increase oxygen delivery to the tissues, including recombinant erythropoietin. Methods for anabolic agents, including designer steroids, have been enhanced through the use of liquid chromatography/tandem mass spectrometry and gas chromatography/combustion/isotope-ratio mass spectrometry. Protein and peptide identification and quantification have benefited from advances in liquid chromatography/tandem mass spectrometry. Incorporation of techniques such as flow cytometry and isoelectric focusing have supported the detection of blood doping.
Collapse
Affiliation(s)
- Larry D Bowers
- United States Anti-Doping Agency, Colorado Springs, Colorado 80906, USA.
| |
Collapse
|
46
|
Thevis M, Kuuranne T, Geyer H, Schänzer W. Annual banned-substance review: the Prohibited List 2008-analytical approaches in human sports drug testing. Drug Test Anal 2009; 1:4-13. [DOI: 10.1002/dta.9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
47
|
Bennett ST. There’s Nothing to Winning, Really. Clin Chem 2008; 54:1265-7. [DOI: 10.1373/clinchem.2008.110411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|