Insulin-like Growth Factor I as a Skeletal Maturity Indicator

Abstract

Introduction: Accurate determination of skeletal maturity and remaining growth is crucial to many orthodontic, orthognathic and dental implant timing decision. Cervical vertebral stages and hand-wrist radiographs are currently used to identify peak mandibular bone growth. These are highly subjective techniques that not only involve radiographic exposure but also lack the ability to determine the intensity of growth spurt and the end of the growth. Insulin-like growth factor I (IGF-I) is a circulating growth hormone-dependent factor whose level correlates with sexual maturity and is used to diagnose growth hormone deficiency and excess. IGF-I level was correlated with cervical skeletal maturity and would be highest at cervical stages that correspond to the greatest amount of facial growth. Materials and methods: Blood sample of 90 patients between the age group of 10 and 25 years of both sexes and their lateral cephalogram were taken. Results: The results showed that the IGF-I levels were low at prepubertal levels, (CS 1, CS 2, CS 3). It increased gradually, peaking during puberty, showing maximum values (CS 4, CS 5), which later dropped to reach prepubertal values (CS 6). Conclusion: Blood spot IGF-I correlates well with skeletal age as determined by radiographic techniques. IGF-I can act as a potential skeletal maturity indicator without the hazard of additional radiographic exposure.

Serum biomarkers associated with radiographic skeletal maturity indicators: A systematic review and meta-analysis

“…A total of 11 studies (13 articles) with the cross-sectional study design (Anusuya et al, 2020; Gupta et al, 2015; Hussain et al, 2013; Ishaq et al, 2012; Jain et al, 2013, 2017; Masoud, 2008; Nancy et al, 2019; Sadiq et al, 2020; Sharmada et al, 2014; Sinha et al, 2016; Tripathi, 2017) utilised lateral cephalograms as the sole method of radiographic skeletal maturity assessment. Out of these studies, four (Ishaq et al, 2012; Jain et al, 2017; Sinha et al, 2016; Tripathi, 2017) used the Hassel and Farman (1995) CVMI staging, while seven (Anusuya et al, 2020; Gupta et al, 2015; Hussain et al, 2013; Jain et al, 2013; Nancy et al, 2019; Sadiq et al, 2020; Sharmada et al, 2014; Tripathi, 2017) used Baccetti et al (2005) CS staging.…”

“…A total of 11 studies (13 articles) with the cross-sectional study design (Anusuya et al, 2020; Gupta et al, 2015; Hussain et al, 2013; Ishaq et al, 2012; Jain et al, 2013, 2017; Masoud, 2008; Nancy et al, 2019; Sadiq et al, 2020; Sharmada et al, 2014; Sinha et al, 2016; Tripathi, 2017) utilised lateral cephalograms as the sole method of radiographic skeletal maturity assessment. Out of these studies, four (Ishaq et al, 2012; Jain et al, 2017; Sinha et al, 2016; Tripathi, 2017) used the Hassel and Farman (1995) CVMI staging, while seven (Anusuya et al, 2020; Gupta et al, 2015; Hussain et al, 2013; Jain et al, 2013; Nancy et al, 2019; Sadiq et al, 2020; Sharmada et al, 2014; Tripathi, 2017) used Baccetti et al (2005) CS staging. Though the CS staging by Baccetti et al (2005) was employed by eight studies, five studies—namely Anusuya et al (2020), Gupta et al (2015), Hussain et al (2013), Masoud (2008) and Sharmada et al (2014)—allocated their respective participants into six stages (CS 1–6) whereas Nancy et al (2019) and Sadiq et al (2020) did not include participants in the CS1 stage.…”

“…Out of these studies, four (Ishaq et al, 2012; Jain et al, 2017; Sinha et al, 2016; Tripathi, 2017) used the Hassel and Farman (1995) CVMI staging, while seven (Anusuya et al, 2020; Gupta et al, 2015; Hussain et al, 2013; Jain et al, 2013; Nancy et al, 2019; Sadiq et al, 2020; Sharmada et al, 2014; Tripathi, 2017) used Baccetti et al (2005) CS staging. Though the CS staging by Baccetti et al (2005) was employed by eight studies, five studies—namely Anusuya et al (2020), Gupta et al (2015), Hussain et al (2013), Masoud (2008) and Sharmada et al (2014)—allocated their respective participants into six stages (CS 1–6) whereas Nancy et al (2019) and Sadiq et al (2020) did not include participants in the CS1 stage. The article by Jain et al (2013) evaluated the study participants only in CS 3–5.…”

“…Hussain et al (2013) (47 male and 43 female participants; age rang = 5–20 years), Sharmada et al (2014) (49 female and 41 male participants; age range = 10–25 years), Gupta et al (2014) (30 female and 30 male participants; age range = 8–23 years) and Anusuya et al, (2020) (mean age = 13.65 ± 4.01 years; age range = 7–21 years) allocated their respective study samples into six stages (CS 1–6) whereas Nancy et al (2019) and Sadiq et al (2020) did not include samples in the CS1 stage. The study by Jain et al (2013) evaluated the sample of 45 male participants only in three CS stages, namely CS 3–5.…”

“…The levels of IGF-1 were evaluated in blood spot by two studies—namely Masoud (2008) and Sharmada et al (2014)—and serum by 10 studies—namely Dhoka et al (2019), Gupta et al (2012, 2015), Ishaq et al (2012), Jain et al (2013), Nancy et al (2019), Phogat et al (2015), Sadiq et al (2020) and Sinha et al (2014, 2016). Srinivasan and Premkumar (2012) and Venkatagiriappa et al (2016) assessed the DHEA levels in serum and blood spot, respectively.…”