Insulin-like Growth Factor 1 (IGF-1)

CPT: 84305
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Synonyms

  • IGF-1
  • SM-C/IGF-1

Special Instructions

This test may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H, or coenzyme R). It is recommended to ask all patients who may be indicated for this test about biotin supplementation. Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample.


Expected Turnaround Time

2 - 4 days



Related Documents


Specimen Requirements


Specimen

Serum


Volume

0.5 mL


Minimum Volume

0.2 mL (Note: This volume does not allow for repeat testing.)


Container

Red-top tube or gel-barrier tube


Collection

Separate serum from cells. Transfer separated serum to a plastic transport tube. Please include the patient's age on the test request form.


Storage Instructions

Refrigerate.


Stability Requirements

Temperature

Period

Room temperature

3 days

Refrigerated

7 days

Frozen

90 days

Freeze/thaw cycles

Stable x3


Causes for Rejection

Plasma specimen


Test Details


Use

The IDS-iSYS Insulin-like Growth Factor-I (IGF-I) assay is an in vitro diagnostic device intended for the quantitative determination of IGF-I in human serum or plasma on the IDS system. Results are to be used in conjunction with other clinical and laboratory data to assist the clinician in the assessment of growth disorders.


Limitations

Malnutrition will cause low somatomedin-C levels in spite of normal amounts of circulating growth hormone. The Sm-C level does not distinguish pituitary dwarfism from constitutional delay of growth and development.2


Methodology

Immunochemiluminometric assay (ICMA)


Reference Interval

See table.1

Insulin-like Growth Factor 1 (IGF-1)

Age

(y)

Male

(ng/mL)

Female

(ng/mL)

Age

(y)

Male

(ng/mL)

Female

(ng/mL)

<1

18−79

14−106

18

145−506

117−430

1

20−108

23−136

19

122−435

113−408

2

24−135

30−163

20

116−410

108−384

3

28−148

34−192

21 to 25

109−353

101−347

4

32−165

38−217

26 to 30

101−307

91−308

5

37−196

46−243

31 to 35

95−290

84−281

6

43−229

56−268

36 to 40

90−278

79−259

7

50−243

64−288

41 to 45

84–270

74−239

8

59−275

74−337

46 to 50

81−263

70−225

9

67−315

81−405

51 to 55

74-−255

65−216

10

75−366

85−526

56 to 60

68−247

60−207

11

82−423

91−610

61 to 65

64−240

57−202

12

87−519

110−656

66 to 70

59−230

52−196

13

101–620

150–678

71 to 75

53−222

48−191

14

123−701

174−656

76 to 80

45−207

42−185

15

161−760

156−586

81 to 85

40−194

39−177

16

171−748

140−517

86 to 90

33−176

34−169

17

161−635

130−471

>90

Not established

Not established


Additional Information

IGF-1 is a relatively small peptide (molecular weight 7647) that is tightly bound in serum to one of several high affinity binding proteins.1 IGF-1 has approximately 50% sequence homology with proinsulin and has a number of biological activities similar to insulin. IGF-1 is a hormone that serves as the major effector of GH-stimulated somatic growth, as well as GH-independent anabolic responses in numerous tissues. IGF-1 has numerous growth-promoting effects, including mitogenic effects and the promotion of cartilage sulfation. Measurement of serum IGF-1 has been widely used in the diagnosis of disorders of GH secretion,2-6 management of disorders that lead to nutritional insufficiency, or catabolism,7-9 and monitoring both GH and IGF-1 replacement therapy. IGF-1 measurement may also have a role in the physiology of malignant disease.10,11

The IDS iSYS IGF-1 assay conforms to the recommendations outlined in the recently published consensus statement on the standardization and evaluation of IGF-1 assays.12 The assay is calibrated to the WHO recombinant reference standard 02/254 for IGF-1.13 Reference intervals for IGF-I using the IDS IGF-I were determined in a clinical routine study population from the United States.13,14 The cohort included 778,173 males and 710,752 females, aged from 0 to 90 years, who were representative of the overall United States population in terms of gender, race and ethnicity. Reference intervals were adjusted for age and sex using a modified Hoffman approach.15


Footnotes

1. Holly JM, Perks CM. Insulin-like growth factor physiology: What we have learned from human studies. Endocrinol Metab Clin North Am. 2012 Jun;41(2):249-263.22682629
2. Clemmons DR. Clinical laboratory indices in the treatment of acromegaly. Clin Chim Acta. 2011 Feb 20;412(5-6):403-409.21075098
3. Melmed S, Colao A, Barkan A, et al. Guidelines for acromegaly management: An update. J Clin Endocrinol Metab. 2009 May;94(5):1509-1517.19208732
4. Katznelson L, Atkinson JL, Cook DM, et al. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the diagnosis and treatment of acromegaly--2011 update. Endocr Pract. 2011 Jul-Aug;17(Suppl 4):1-44.21846616
5. Molitch ME, Clemmons DR, Malozowski S, Merriam GR, Vance ML; Endocrine Society. Evaluation and treatment of adult growth hormone deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011 Jun;96(6):1587-1609.21602453
6. Cook DM, Yuen KC, Biller BM, Kemp SF, Vance ML; American Association of Clinical Endocrinologists. American Association of Clinical Endocrinologists medical guidelines for clinical practice for growth hormone use in growth hormone-deficient adults and transition patients−2009 update. Endocr Pract. 2009 Sep-Oct;15(Suppl 2):1-29.20228036
7. Friedrich N, Thuesen B, Jrgensen T, et al. The association between IGF-I and insulin resistance: A general population study in Danish adults. Diabetes Care. 2012 Apr;35(4):768-773.22374641
8. Kreitschmann-Andermahr I, Suárez P, Jennings R, Evers N, Brabant G. GH/IGF-I regulation in obesity--mechanisms and practical consequences in children and adults. Horm Res Peadiatr. 2010;73(3):153-160.20197666
9. Clemmons DR. Metabolic actions of insulin-like growth factor-I in normal physiology and diabetes. Endocrinol Metab Clin North Am. 2012 Jun;41(2):425-443, vii-viii.22682639
10. Endogenous Hormones and Breast Cancer Collaborative Group, Key TJ, Appleby PN, Reeves GK, Roddam AW. Insulin-like growth factor 1 (IGF1), IGF binding protein 3 (IGFBP3), and breast cancer risk: Pooled individual data analysis of 17 prospective studies. Lancet Oncol. 2010 Jun;11(6):530-542.20472501
11. Khosravi J, Diamandi A, Mistry J, Scorilas A. Insulin-like growth factor I (IGF-I) and IGF-binding protein-3 in benign prostatic hyperplasia and prostate cancer. J Clin Endocrinol Metab. 2001 Feb;86(2):694-699.11158033
12. Clemmons DR. Consensus statement on the standardization and evaluation of growth hormone and insulin-like growth factor assays. Clin Chem. 2011 Apr;57(4):555-559.21285256
13. IDS-iSYS Insulin-like Growth Factor-I (IGF-I) [instructions for use]. Boldon, UK: Boldon, Tyne & Wear, 2020.
14. Bidlingmaier M, Valcour A, Schilbach K, et al. Differences in the Distribution of IGF-I Concentrations Between European and US Populations. J Endocr Soc. 2022 May 19;6(7):bvac081.35673402
15. Katayev A, Fleming JK, Luo D, Fisher AH, Sharp TM. Reference intervals data mining: no longer a probability paper method. Am J Clin Pathol. 2015 Jan;143(1):134-142.25511152

References

Daughaday WH, Hall K, Salmon WD Jr, Van den Brande JL, Van Wyk JJ. On the nomenclature of the somatomedins and insulin-like growth factors. J Clin Endocrinol Metab. 1987 Nov;65(5):1075-1076.3667879
DeGroot LJ, Jameson JL, eds. Endocrinology. 4th ed. Philadelphia, Pa: WB Saunders Co; 2001:2257-2268.
Pearson OH, Arafah B, Brodkey J. Management of acromegaly. Ann Intern Med. 1981 Aug;95(2):225-227.7258874
Pintor C, Loche S, Cella SG, Müller EE, Baumann G. A child with phenotypic Laron dwarfism and normal somatomedin levels. N Engl J Med. 1989 Feb 9;320(6):376-379.2913494
Rappaport R, Prevot C, Brauner R. Somatomedin-C and growth in children with precocious puberty: a study of the effect of the level of growth hormone secretion. J Clin Endocrinol Metab. 1987 Dec;65(6):1112-1117.3680478
Underwood LE, D'Ercole AJ. Anterior pituitary gland and hypothalamus: Disorders affecting anterior pituitary function. In: Rudolph AM, Hoffman JI, eds. Pediatrics. 18th ed. Norwalk, Conn: Appleton & Lange; 1987:1454-1465.
Watts NB, Keffer JH. Anterior pituitary and hypothalamus. Practical Endocrinology. 4th ed. Philadelphia, Pa: Lea & Febiger; 1989:11-36.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
010363 IGF-1 2484-4 010369 Insulin-Like Growth Factor I ng/mL 2484-4

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