Key words: Growth Hormone Deficiency, Insulin-like growth factor, IGF-1, Short Stature INTRODUCTION 5 and management . Growth hormone deficiency (GHD) although considered uncommon, is one of the treatable causes Insulin-like growth factor-1 (IGF-1) is an effecter 1 of short stature . Definitive diagnosis of GHD remains hormone which is essential for normal growth in a diagnostic challenge despite passage of about half a humans and has an important role in mediating the 6 century since Growth hormone (GH) is being used as a effect of growth hormone . Several studies have 2 replacement therapy . Various growth hormone shown that serum levels of IGF-1 are growth hormone 7 stimulation tests (GHSTs) have been used to dependent . Measurements of serum IGF-1 discriminate between GHD and idiopathic short concentration seem to be a simple, reliable, relatively stature. This stimulation of GH can be induced by easy to perform test, as a substitute to GHSTs in 8,9 various physiological stimuli like fasting, sleep or diagnosis of GHD . IGF-1 has also been used as a exercise as well as pharmacological stimuli like L- monitoring tool for children receiving growth hormone 10 dopa, clonidine, glucagon, propranolol, arginine or therapy . 2,3,4 insulin infusion . However all these tests lack 4 11,12 reproducibility, accuracy, cost affectivity and safety . Various locally conducted studies have focused on 13 Apart from a number of clear genetic causes of GHD, GHSTs but very few studies have evaluated the role of the diagnostic gold standard remains elusive. IGF-1 in diagnosis of GHD in short stature children. Nevertheless correct diagnosis has significant Therefore a clinical trial was planned at Shalamar benefits to the child guiding both future investigations Medical & Dental College for this purpose. ABSTRACT...Introduction: Despite the use of growth hormone replacement therapy for decades, our ability to make a definitive diagnosis of growth hormone deficiency in children is limited. Growth hormone stimulation tests have been used to discriminate between Growth hormone deficiency and idiopathic short stature. However all these tests lack reproducibility, accuracy, cost affectivity and safety. Insulin- like growth factor-1 is an effector hormone and its serum level may be used as simple, easy to perform diagnostic test for growth hormone deficiency. Objective: To determine the efficacy of IGF-1 as a diagnostic tool in children with growth hormone deficiency. Study Design: Prospective cross sectional survey. Place of Study: Departments of Pediatrics and Pathology, Shalamar Medical & Dental College, Lahore. Duration of study: 1st July to 31st December, 2011. Material & Methods: We included 40 children of 3.5 – 17 year age and detailed clinical data was collected. All these children were subjected to stimulation by standardized exercise on treadmill, after taking basal blood samples for GH and IGF-1. Post stimulation growth hormone was recorded to identify growth hormone deficient children. Results: 17 (42.5%) children had post stimulation growth hormone level <10ng/ml while 23 (57.5%) had values >10ng/ml. Post exercise stimulation GH level showed weak correlation with IGF-1 in either of the two study groups. P value was found >0.05 in deficient as well as sufficient groups, depicting non significance of IGF-1 in relation to post stimulation GH level. Conclusions: IGF-1 is not a suitable surrogate diagnostic marker for growth hormone deficiency. Diagnosis should always be based on combination of auxological biochemical, radiological and genetic considerations, Abbreviations: GHD – Growth Hormone Deficiency, GH – Growth Hormone, GHSTs – Growth Hormone Stimulation Tests, IGF-1 – Insulin-like Growth Factor-1, MPH – Mid Parental Height, BA – Bone Age. GROWTH HORMONE ESTIMATION; Insulin-like growth factor-1 a possible alternative ORIGINAL PROF-2151 Professional Med J 2013;20(3): 385-389. 385 www.theprofesional.com Hameed MN, Sadiq F, Mumtaz A, Mohiuddin H, Khan S, Quereshi TJ. Growth Hormone Estimation; Insulin-like growth factor-1 a possible alternative. Professional Med J 2013;20(3): 385-389. Article Citation Dr. M. Nadeem Hameed, Dr. Fauzia Sadiq, Dr. Asim Mumtaz, Dr. Hina Mohiuddin, Dr. Sana Khan, Dr. Tariq Jaffar Quereshi