Insulin-Like Growth Factor-1 and Insulin-Like Growth Factor Binding Protein-3 - Biomarkers for Skeletal Maturity Assessment in Class II Malocclusion

Yezdani, Arif; Padmavathy, Kesavaram; Kumar, Kishore

doi:10.1590/pboci.2024.047

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ORIGINAL ARTICLE • Pesqui. Bras. Odontopediatria Clín. Integr. 24 • 2024 • https://doi.org/10.1590/pboci.2024.047 copy

Insulin-Like Growth Factor-1 and Insulin-Like Growth Factor Binding Protein-3 - Biomarkers for Skeletal Maturity Assessment in Class II Malocclusion

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To estimate the serum levels of non-radiologic biomarkers, Insulin-like Growth Factor-1 (IGF-1), and Insulin-like Growth Factor Binding Protein-3 (IGFBP-3) to potentially identify the pubertal growth spurt in skeletal Class II malocclusion subjects.

Material and Methods:

Eighty subjects (M-38, F-42) with skeletal Class II malocclusion in the age range of 11-18 years were recruited for the cross-sectional study. Human serum IGF-1 and IGFBP-3 were quantitatively assessed by enzyme-linked immunosorbent assay, and the cervical stage (CS) was evaluated from a lateral cephalogram.

Results:

Gender-wise comparison of the mean serum IGF-1 levels revealed that the initial peak was detected at CS2 in both genders, [males (87.87 ng/mL), females (78.49 ng/mL)]. However, there was a cognizable difference in the second peak of the mean serum IGF-1 levels between males (CS5, 68.58 ng/mL) and females (CS4, 74.63 ng/mL). Mean IGFBP-3 serum levels in male subjects were high in CS4 (47.24 ng/mL) with a further spike in CS6 (50.54 ng/mL), and in female subjects, it was found to be highest in CS3 (51.95 ng/mL) and then in CS5 (49.68 ng/mL).

Conclusion:

Mean IGF-1 levels exhibited both sexes' prepubertal and late pubertal spikes. Mean IGFBP-3 levels revealed a pubertal and a late pubertal spike in both sexes, with an earlier growth trend observed specific to females compared to males.

Keywords:
Malocclusion; Angle Class II; Growth and Development; Puberty; Cervical Vertebrae

Cervical Stages	No of Subjects	Mean Age (Years)	Mean IGF-1 (ng/mL) ± SD	Standard Error	95% CI
Cervical Stages	No of Subjects	Mean Age (Years)	Mean IGF-1 (ng/mL) ± SD	Standard Error	LL	UL
Male Group - IGF-1(ng/mL) serum levels in males (n=38) at each cervical stage^{^* * p=0.286 (NS);}
CS 2	8	11.50	87.87 ± 7.53	2.66	81.57	94.17
CS 3	10	13.40	57.45 ± 40.87	12.92	28.21	86.69
CS 4	9	13.89	51.96 ± 46.69	15.56	16.07	87.84
CS 5	4	16.75	68.58 ± 43.47	21.73	-.59	137.74
CS 6	7	16.71	53.72 ± 36.34	13.73	20.11	87.33
Female Group - IGF-1(ng/mL) serum levels in females (n=42) at each cervical stage^{^ p=0.465 (NS)}
CS 2	4	12.25	78.49 ± 21.93	10.96	43.60	113.38
CS 3	3	12.67	27.52 ± 55.71	32.16	-110.88	165.91
CS 4	10	13.40	74.63 ± 30.10	9.52	53.10	96.16
CS 5	19	15.79	52.84 ± 43.47	9.46	32.96	72.72
CS 6	6	16.00	45.93 ± 43.15	17.61	.65	91.21

Cervical Stage Intervals	No of Subjects	Mean Age (Years)	Mean IGF-1 (ng/mL) ± SD	SEM	95% CI for Mean		Median	IGF - 1 (ng/mL)
Cervical Stage Intervals	No of Subjects	Mean Age (Years)	Mean IGF-1 (ng/mL) ± SD	SEM	LL	UL	Median	Min.	Max.
Male Group - IGF-1 (ng/mL) serum levels at each interval of cervical stage^{^* * p=0.816 (NS);}
CS2 - CS3	18	12.56	70.97 ± 33.91	7.99	54.11	87.83	88.95	-5	93
CS3 - CS4	19	13.63	54.85 ± 42.57	9.77	34.33	75.37	78.53	-5	93
CS4 - CS5	13	14.77	57.07 ± 44.60	12.37	30.12	84.02	88.58	-1	93
CS5 - CS6	11	16.73	59.12 ± 37.62	11.34	33.85	84.40	86.69	3	93
Female Group - IGF-1 (ng/mL) serum levels at each interval of cervical stage^{^ p=0.916 (NS).}
CS2 - CS3	7	12.43	56.64 ± 44.91	16.98	15.11	98.18	83.93	-12	93
CS3 - CS4	13	13.23	63.76 ± 40.30	11.18	39.41	88.11	87.66	-12	93
CS4 - CS5	29	14.97	60.35 ± 38.68	7.18	45.64	75.07	77.67	-10	93
CS5 - CS6	25	15.84	51.18 ± 40.90	8.18	34.29	68.06	67.31	-10	93

Cervical Stages	No of Subjects	Mean Age (Years)	Mean IGFBP-3 (ng/mL) ± SD	Standard Error of Mean	95% CI for Mean
Cervical Stages	No of Subjects	Mean Age (Years)	Mean IGFBP-3 (ng/mL) ± SD	Standard Error of Mean	LL	UL
Male Group - IGFBP-3 (ng/mL) serum levels in males (n=38) at each cervical stage^{^* * p=0.211 (NS);}
CS 2	8	11.5	35.03 ± 11.65	4.12	25.29	44.76
CS 3	10	13.4	36.74 ± 23.22	7.34	20.13	53.35
CS 4	9	13.9	47.24 ± 13.23	4.41	37.08	57.41
CS 5	4	16.8	41.72 ± 17.00	8.50	14.66	68.78
CS 6	7	16.7	50.54 ± 9.65	3.65	41.62	59.47
Female Group - IGFBP-3 (ng/mL) serum levels in females (n=42) at each cervical stage^{^ p=0.711 (NS).}
CS 2	4	12.3	39.47± 25.88	12.94	-1.72	80.66
CS 3	3	12.7	51.95± 18.73	10.81	5.42	98.49
CS 4	10	13.4	47.63± 14.33	4.53	37.38	57.88
CS 5	19	15.8	49.68± 17.07	3.92	41.45	57.91
CS 6	6	16.0	38.10± 20.03	8.18	17.08	59.12

Cervical Stage Intervals	Mean IGFBP-3 (ng/mL) ± SD	SEM	95% CI for Mean		Median	IGFBP-3 (ng/mL)
Cervical Stage Intervals	Mean IGFBP-3 (ng/mL) ± SD	SEM	LL	UL	Median	Min.	Max.
Male Group - IGFBP-3 (ng/mL) serum levels at each interval of cervical stage^{^* * p=0.237 (NS);}
CS2 - CS3	35.98 ± 18.50	4.36	26.78	45.18	36.81	1	69
CS3 -CS4	41.72 ± 19.40	4.45	32.37	51.07	45.78	1	69
CS4 - CS5	45.54 ± 14.00	3.88	37.08	54.00	49.38	16	69
CS5 - CS6	47.33 ± 12.75	3.84	38.77	55.90	49.38	16	62
Female Group - IGFBP-3 (ng/mL) serum levels at each interval of cervical stage^{^ p=0.829 (NS).}
CS2 - CS3	44.82 ± 22.28	8.42	24.21	65.43	51.69	1	64
CS3 - CS4	48.63 ± 14.70	4.08	39.74	57.51	53.90	21	64
CS4 - CS5	48.97 ± 15.95	2.96	42.90	55.04	49.94	19	98
CS5 - CS6	46.90 ± 18.10	3.62	39.43	54.37	49.79	2	98

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[1] Corresponding author: Arif Yezdani E-mail:arifyezdani@yahoo.com