胰岛素样生长因子-1

胰岛素样生长激素-1试验是一种间接测量体内产生生长激素量的平均值的方法。 IGF-1和生长激素都是多肽类激素，对骨骼和组织的生长发育起着极其重要的作用。生长激素由脑垂体产生的，脑垂体是位于鼻后大脑底部一个葡萄大小的腺体。生长激素分泌呈明显的昼夜节律波动，在夜间达高峰。IGF-1 由肝脏产生，在骨骼肌的含量比较少，主要受到生长激素的刺激而分泌。它调节生长激素的许多功能，刺激骨骼和其他组织的生长和促进肌肉组织的产生。IGF-1可以反映生长激素过量和不足，但它的水平昼夜是稳定的，这使它成为反应生长激素平均水平的很好的指示剂。

        正常情况下，如同生长激素，幼童时期的　IGF-1比较低，孩童时期逐渐升高，青春期达到高峰，成人后减退。生长激素和IGF-1不足可由垂体功能减退症和激素产生细胞受损的非生长激素产生的垂体瘤的存在而导致。IGF-1不足也可发生在对生长激素无反应时。这种反应不敏感原因可能以遗传性为主，其次是营养不良和慢性病。

        IGF-1分泌不足最初可抑制骨骼生长并影响发育的整个阶段最终导致儿童的身高低于正常水平。在成人，分泌不足可导致骨密度降低，肌力下降，和脂质改变。

        生长激素和IGF-1过剩可以导致骨骼生长异常和其他体征如：巨人症和肢端肥大症。在儿童期，巨人症导致骨骼生长时间延长，最终导致成为一个有手脚巨大的非常高的人。在成人期，肢端肥大症导致骨骼增厚和软组织肿大（如鼻子）。这两种情况都导致器官（如心脏）增大，及其它并发症如II型糖尿病、心血管疾病的危险性增加、高血压、关节炎、寿命缩短。脑垂体分泌过量生长激素最常见的原因是分泌生长激素的垂体瘤（通常是良性的）。肿瘤通常可以通过外科手术和/或药物或者放射治疗移除。大多数情况下，生长激素和IGF-1的水平就会恢复或接近正常。

通过手臂静脉采血或者指尖针刺采血（儿童）得到的血标本。

一般而言，不需要准备；但因为这个测试可能和其他检查同时进行，需要禁食至少12小时。

疾病: 垂体障碍

National Institute of Diabetes and Digestive and Kidney Diseases: Acromegaly
The Magic Foundation: Introduction to Insulin-like Growth Factor Deficiency

S1
Thomas, Clayton L., Editor (1997). Taber’s Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].

S2
Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby’s Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO.

S3
Thorner, M. et. al. (2003 September 24). Advanced Strategies for Achieving IGF-I Control in Acromegaly [71 paragraphs]. The Endocrine Society [CME on Medscape]. Available FTP: http://www.medscape.com/viewprogram/2638_pnt

S4
Cromie, W. (1999 April 22). Growth Factor Raises Cancer Risk [23 paragraphs]. Harvard Gazette Archives [On-line article]. Available FTP: http://www.news.harvard.edu/gazette/1999/04.22/igf1.story.html

S5
IGF-1 (Insulin-Like Growth Factor 1) [4 paragraphs]. ARUP Guide to Clinical Laboratory Testing. [On-line information]. Available FTP: http://www.arup-lab.com/guides/clt/tests/clt_al3b.jsp#1349162

S6
Growth Hormone (Human Growth Hormone, HGH, Somatotropin) [4 paragraphs]. Acromegaly, ARUP Guide to Clinical Laboratory Testing. [On-line information]. Available FTP: http://www.arup-lab.com/guides/clt/tests/clt_al3b.jsp#1349162

S7
(2002 Int J Cancer). Elevated IGF-1 Linked to Risk of Ovarian Cancer in Younger Women [5 paragraphs]. National Cancer Institute, CTEP, From Int J Cancer 101:549-554. [On-line information]. Available FTP: http://ctep.info.nih.gov/resources/gcig/news102902.html

S8
Mayo Clinic Staff (2003 May 08). Acromegaly [26 paragraphs]. MayoClinic.com [On-line information]. Available FTP: http://www.mayoclinic.com/invoke.cfm?id=DS00478

S9
(2002 June). Acromegaly [24 paragraphs]. NIDDK, NIH Publication No. 02-3924 [On-line information]. Available FTP: http://www.niddk.nih.gov/health/endo/pubs/acro/acro.htm

S10
(2002) Acromegaly [13 paragraphs] MEDLINEplus Health Information, Medical Encyclopedia [On-line information]. Available FTP: http://www.nlm.nih.gov/medlineplus/ency/article/000321.htm

S11
(2004 January 23). Unsportsmanlike behavior [7 paragraphs]. The Washington Times [On-line article]. Available FTP: http://www.washingtontimes.com/functions/print.php?StoryID=20040122-082812-2585r

S12
Kass, L. and Council (2003 October). Chapter Three, Superior Performance [121 paragraphs]. Beyond Therapy: Biotechnology and the Pursuit of Happiness, The President's Council on Bioethics [On-line report]. Available FTP: http://bioethicsprint.bioethics.gov/reports/beyondtherapy/index.html

S13
(2003 May 30). Race to develop drug abuse test [19 paragraphs]. BBC News [On-line article]. Available FTP: http://news.bbc.co.uk/1/hi/health/2946344.stm

S14
Acromegaly and Gigantism [15 paragraphs]. Merck Manual Second Home Edition [On-line information]. Available FTP: http://www.merck.com/mrkshared/mmanual_home2/sec13/ch162/ch162e.jsp

S15
Clemmons, D. (2004 January 1). The relative roles of growth hormone and IGF-1 in controlling insulin sensitivity [6 paragraphs]. J Clin Invest 113(1): 25-27 [On-line article]. Available FTP: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=300772

S16
(2003 April 14, Updated). Growth Hormone [24 paragraphs]. Index of the Hypothalamus and Pituitary Gland, Colorado State University Hypertext [On-line information]. Available FTP: http://arbl.cvmbs.colostate.edu/hbooks/pathphys/endocrine/hypopit/gh.html

S17
(2003 February 18, Updated). Growth Hormone and Aging [9 paragraphs]. Index of the Hypothalamus and Pituitary Gland, Colorado State University Hypertext [On-line information]. Available FTP: http://arbl.cvmbs.colostate.edu/hbooks/pathphys/endocrine/hypopit/ghaging.html

S18
Pagana, Kathleen D. & Pagana, Timothy J. (© 2007). Mosby’s Diagnostic and Laboratory Test Reference 8th Edition: Mosby, Inc., Saint Louis, MO. Pp 879 – 880.

S19
Clarke, W. and Dufour, D. R., Editors (2006). Contemporary Practice in Clinical Chemistry. AACC Press, Washington, DC. Grenache, D and Willis, M., Chapter 31, Hypothalamic, Pituitary, and Gonadal Disorders. Pp 351-363.

S20
Wu, A. (2006). Tietz Clinical Guide to Laboratory Tests, Fourth Edition. Saunders Elsevier, St. Louis, Missouri. Pp 626-628.

S21
Sheppard, M. (2007 April 3). Growth Hormone Assay Standardization: An Important Clinical Advance [7 paragraphs]. Medscape from Clin Endocrinol. 2007;66(2):157-161. [On-line information]. Accessed on: 8/18/07 Available FTP: http://www.medscape.com/viewarticle/553885

S22
(2007 April). Acromegaly [24 paragraphs]. NIDDK, NIH Publication No. 02-3924 [On-line information, accessed September 2007]. Available FTP: http://www.niddk.nih.gov/health/endo/pubs/acro/acro.htm