Insulin-like Growth Factor 1 (IGF-1)

CPT: 84305
Print Share

Test Details

Synonyms

  • IGF-1
  • SM-C/IGF-1
  • Somatomedin-C, Sulfation Factor

Use

Results of the insulin-like growth factor-1 assay 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

27−157

18−126

18

146−494

121−486

1

30−167

20−132

19

140−463

114−451

2

34−184

22−145

20

133−430

108−416

3

39−205

26−164

21 to 25

115−355

93−342

4

44−225

31−188

26 to 30

98−282

78−270

5

50−246

36−214

31 to 35

88−246

73−243

6

56−267

42−240

36 to 40

83−233

69−227

7

63−292

49−267

41 to 45

75−216

62−204

8

72−323

57−305

46 to 50

67−205

57−195

9

84−362

67−349

51 to 55

61−200

53−190

10

97−407

80−400

56 to 60

54−194

46−172

11

112−454

93−453

61 to 65

49−188

42−169

12

126−499

105−499

66 to 70

47−192

38−163

13

139−533

116−533

71 to 75

41−179

37−165

14

148−551

123−552

76 to 80

37−172

35−165

15

152−554

127−554

81 to 85

34−165

34−172

16

153−542

128−542

86 to 90

32−166

34−178

17

151−521

125−517

>90

Not established

Not established

Tanner Stage

Stages

Male

Female

I

81−255

86−323

II

106−432

118−451

III

245−511

258−529

IV

223−578

224−586

V

227−518

188−512

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. Reference intervals were developed through a multicenter study with samples from 12 cohorts from the USA, Canada, and Europe.13 In total, 15,014 subjects were tested (6697 males and 8317 females), ranging in ages from 0 to 94 years. Results are reported in mass units with reference intervals reflecting the central 95% interval (2.5 to 97.5 percentiles).

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

Clinical Information

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.

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, et al. 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 J1, 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. Bidlingmaier M, Friedrich N, Emeny RT, et al. Reference intervals for insulin-like growth factor 1 (IGF-1) from birth to senescence: Results from a multicenter study using a new automated chemiluminescence IGF-1 immunoassay conforming to recent international recommendations. J Clin Endocrinol Metab. 2014 May;99(5):1712-1721. 24606072

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

For Providers

Please login to order a test.

 

© 2018  Laboratory Corporation of America® Holdings and Lexi-Comp Inc. All Rights Reserved.

CPT Statement/Profile Statement

The LOINC® codes are copyright © 1994-2018, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. Permission is granted in perpetuity, without payment of license fees or royalties, to use, copy, or distribute the LOINC® codes for any commercial or non-commercial purpose, subject to the terms under the license agreement found at https://loinc.org/license/. Additional information regarding LOINC® codes can be found at LOINC.org, including the LOINC Manual, which can be downloaded at LOINC.org/downloads/files/LOINCManual.pdf