Insulin-like growth factor-binding protein-2 levels in pediatric patients with growth hormone deficiency, eating disorders and acute lymphoblastic leukemia

Area of Science:

• Endocrinology
• Pediatrics
• Biochemistry

Background:

• Insulin-like Growth Factor (IGF)-binding protein-2 (IGFBP-2) levels are altered in various diseases, potentially indicating disease severity.
• The precise role and developmental pattern of IGFBP-2 require further investigation, particularly concerning its relationship with the growth hormone (GH)-IGF axis.

Purpose of the Study:

• To establish reference values for serum IGFBP-2 during development from birth through adolescence.
• To evaluate IGFBP-2 as a potential diagnostic and prognostic marker in conditions involving the GH-IGF axis, including congenital GH deficiency (GHD), acute lymphoblastic leukemia (ALL), obesity, and anorexia nervosa (AN).
• To explore the correlation between IGFBP-2 and other key components of the GH-IGF axis, such as IGF-I, its free fraction, IGFBP-1, and IGFBP-3.

Main Methods:

• Serum IGFBP-2 concentrations were measured in 55 healthy newborns and 221 healthy children across different Tanner stages.
• IGFBP-2 levels were analyzed at diagnosis and during follow-up in children with GHD, ALL, obesity, and AN.
• Statistical analysis, including ANOVA, was employed to compare IGFBP-2 levels between groups and assess correlations.

Main Results:

• Serum IGFBP-2 levels were significantly higher in newborns compared to children in Tanner stages I-V, with no further developmental changes observed.
• At diagnosis, IGFBP-2 levels were elevated in GHD, ALL, and AN, but decreased in obesity (p < 0.05).
• During follow-up, IGFBP-2 concentrations showed a trend toward normalization. Positive correlations were found between IGFBP-2 and IGFBP-1, while negative correlations existed with IGF-I and IGFBP-3.

Conclusions:

• IGFBP-2 exhibits distinct concentration patterns during early development and in specific pediatric diseases.
• Altered IGFBP-2 levels in GHD, ALL, AN, and obesity suggest its involvement in the GH-IGF axis dysregulation characteristic of these conditions.
• IGFBP-2 may serve as a valuable biomarker for diagnosing and monitoring diseases impacting the GH-IGF axis, despite its exact functions remaining unclear.