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Biochemical markers of insulin-like growth factor-I misuse in athletes: the response of serum IGF-I, procollagen type III amino-terminal propeptide, and the GH-2000 score to the administration of rhIGF-I/rhIGF binding protein-3 complex

Biochemical markers of insulin-like growth factor-I misuse in athletes: the response of serum IGF-I, procollagen type III amino-terminal propeptide, and the GH-2000 score to the administration of rhIGF-I/rhIGF binding protein-3 complex
Biochemical markers of insulin-like growth factor-I misuse in athletes: the response of serum IGF-I, procollagen type III amino-terminal propeptide, and the GH-2000 score to the administration of rhIGF-I/rhIGF binding protein-3 complex
Context: The GH-2000 and GH-2004 research groups developed a method for detecting GH misuse in athletes based on the measurement of serum IGF-I and procollagen type III amino-terminal propeptide (P-III-NP). There are reports that IGF-I is also misused by athletes, but currently there is no internationally recognized test designed to detect recombinant human IGF-I misuse.

Objective: The objective of the study was to examine the response of serum IGF-I, P-III-NP, and the GH-2000 score to recombinant human (rh) IGF-I/rhIGF binding protein-3 (IGFBP-3) administration in recreational athletes.

Design and Setting: This was a randomized, double-blind, placebo-controlled rhIGF-I/rhIGFBP-3 administration study at Southampton General Hospital (Southampton, United Kingdom).

Participants: Fifty-six recreational athletes (26 women, 30 men) participated in the study.

Intervention: Participants were randomized to treatment with low-dose (30 mg/d) or high-dose (60 mg/d) rhIGF-I/rhIGFBP-3 complex or placebo for 28 days. Blood was collected throughout the drug administration and washout periods. Serum IGF-I and P-III-NP were measured using commercial immunoassays and GH-2000 scores were calculated.

Results: IGF-I, P-III-NP, and the GH-2000 score rose in response to both low- and high-dose rhIGF-I/rhIGFBP-3 administration. The relative maximum response of IGF-I (approximately 4-fold increase in women and men) was greater than that of P-III-NP (40%–50% increase in women, 35%–50% increase in men). The GH-2000 formulae, which incorporate IGF-I and P-III-NP results, detected up to 61% of women and 80% of men in the rhIGF-I/rhIGFBP-3 groups but, using IGF-I concentrations alone, the sensitivity increased to 94% in both women and men during the administration period.

Conclusions: The rise in P-III-NP after rhIGF-I/rhIGFBP-3 administration is small compared with that after rhGH administration. Although rhIGF-I/rhIGFBP-3 administration can be detected using the GH-2000 score method, a test based on serum IGF-I alone provides better sensitivity.
0021-972X
2259-2268
Guha, Nishan
38212040-a65e-4874-a60a-21f0ae3bdf09
Erotokritou-Mulligan, Ioulietta
8bb8720a-eda7-4ad4-b969-0b35c5e5226c
Bartlett, Christiaan
ed9cba27-96ef-419e-824b-fabab5c7cba8
Nevitt, Simon P.
c3b28987-b9cb-4c9a-96d8-dd543bbe482c
Francis, Michael
93112f9d-8b2b-454b-ab6f-7f0d286f09e0
Bassett, E. Eryl
fefd7f16-2045-4700-adaa-7cc6049933a4
Cowan, David A.
22bdafa8-cee8-481a-97d5-2687fcf325ca
Sonksen, Peter H.
5d27a08a-0f31-47a2-957c-b5aace71bf00
Holt, Richard I.G.
d54202e1-fcf6-4a17-a320-9f32d7024393
Guha, Nishan
38212040-a65e-4874-a60a-21f0ae3bdf09
Erotokritou-Mulligan, Ioulietta
8bb8720a-eda7-4ad4-b969-0b35c5e5226c
Bartlett, Christiaan
ed9cba27-96ef-419e-824b-fabab5c7cba8
Nevitt, Simon P.
c3b28987-b9cb-4c9a-96d8-dd543bbe482c
Francis, Michael
93112f9d-8b2b-454b-ab6f-7f0d286f09e0
Bassett, E. Eryl
fefd7f16-2045-4700-adaa-7cc6049933a4
Cowan, David A.
22bdafa8-cee8-481a-97d5-2687fcf325ca
Sonksen, Peter H.
5d27a08a-0f31-47a2-957c-b5aace71bf00
Holt, Richard I.G.
d54202e1-fcf6-4a17-a320-9f32d7024393

Guha, Nishan, Erotokritou-Mulligan, Ioulietta, Bartlett, Christiaan, Nevitt, Simon P., Francis, Michael, Bassett, E. Eryl, Cowan, David A., Sonksen, Peter H. and Holt, Richard I.G. (2014) Biochemical markers of insulin-like growth factor-I misuse in athletes: the response of serum IGF-I, procollagen type III amino-terminal propeptide, and the GH-2000 score to the administration of rhIGF-I/rhIGF binding protein-3 complex. Journal of Clinical Endocrinology & Metabolism, 99 (6), 2259-2268. (doi:10.1210/jc.2013-3897). (PMID:24606087)

Record type: Article

Abstract

Context: The GH-2000 and GH-2004 research groups developed a method for detecting GH misuse in athletes based on the measurement of serum IGF-I and procollagen type III amino-terminal propeptide (P-III-NP). There are reports that IGF-I is also misused by athletes, but currently there is no internationally recognized test designed to detect recombinant human IGF-I misuse.

Objective: The objective of the study was to examine the response of serum IGF-I, P-III-NP, and the GH-2000 score to recombinant human (rh) IGF-I/rhIGF binding protein-3 (IGFBP-3) administration in recreational athletes.

Design and Setting: This was a randomized, double-blind, placebo-controlled rhIGF-I/rhIGFBP-3 administration study at Southampton General Hospital (Southampton, United Kingdom).

Participants: Fifty-six recreational athletes (26 women, 30 men) participated in the study.

Intervention: Participants were randomized to treatment with low-dose (30 mg/d) or high-dose (60 mg/d) rhIGF-I/rhIGFBP-3 complex or placebo for 28 days. Blood was collected throughout the drug administration and washout periods. Serum IGF-I and P-III-NP were measured using commercial immunoassays and GH-2000 scores were calculated.

Results: IGF-I, P-III-NP, and the GH-2000 score rose in response to both low- and high-dose rhIGF-I/rhIGFBP-3 administration. The relative maximum response of IGF-I (approximately 4-fold increase in women and men) was greater than that of P-III-NP (40%–50% increase in women, 35%–50% increase in men). The GH-2000 formulae, which incorporate IGF-I and P-III-NP results, detected up to 61% of women and 80% of men in the rhIGF-I/rhIGFBP-3 groups but, using IGF-I concentrations alone, the sensitivity increased to 94% in both women and men during the administration period.

Conclusions: The rise in P-III-NP after rhIGF-I/rhIGFBP-3 administration is small compared with that after rhGH administration. Although rhIGF-I/rhIGFBP-3 administration can be detected using the GH-2000 score method, a test based on serum IGF-I alone provides better sensitivity.

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More information

Accepted/In Press date: 11 February 2014
e-pub ahead of print date: 25 February 2014
Published date: June 2014
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 394654
URI: http://eprints.soton.ac.uk/id/eprint/394654
ISSN: 0021-972X
PURE UUID: c4013832-61f4-4cdf-9948-ffd4de051e2d
ORCID for Richard I.G. Holt: ORCID iD orcid.org/0000-0001-8911-6744

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Date deposited: 23 May 2016 09:25
Last modified: 15 Mar 2024 03:08

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Contributors

Author: Nishan Guha
Author: Ioulietta Erotokritou-Mulligan
Author: Christiaan Bartlett
Author: Simon P. Nevitt
Author: Michael Francis
Author: E. Eryl Bassett
Author: David A. Cowan
Author: Peter H. Sonksen

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