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Influence of Demographic Factors and Sport Type on Growth Hormone-Responsive Markers in Elite Athletes

Context: GH-responsive markers of the IGF system and of collagen turnover hold promise as the basis of a GH doping test. Objective: The purpose of this study was to determine the influence of age, gender, body mass index (BMI), ethnicity, and sporting type on GH-responsive serum markers in a large c...

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Published in:The journal of clinical endocrinology and metabolism 2006-11, Vol.91 (11), p.4424-4432
Main Authors: Nelson, A. E., Howe, C. J., Nguyen, T. V., Leung, K.-C., Trout, G. J., Seibel, M. J., Baxter, R. C., Handelsman, D. J., Kazlauskas, R., Ho, K. K.
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Language:English
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Summary:Context: GH-responsive markers of the IGF system and of collagen turnover hold promise as the basis of a GH doping test. Objective: The purpose of this study was to determine the influence of age, gender, body mass index (BMI), ethnicity, and sporting type on GH-responsive serum markers in a large cohort of elite athletes from different ethnic backgrounds. Design: The study was designed as a cross-sectional study. Participants: A total of 1103 elite athletes (699 males, 404 females), aged 22.2 ± 5.2 yr, from 12 countries and 10 major sporting categories participated in this study. Main Outcome Measures: Serum IGF-I, IGF binding protein-3 (IGFBP-3), acid labile subunit (ALS), and collagen markers [N-terminal propeptide of type I procollagen (PINP), C-terminal telopeptide of type I collagen (ICTP), N-terminal propeptide of type III procollagen (PIIINP)] were measured. Results: There was a significant negative correlation (r = −0.14 to −0.58, P < 0.0005) between age and each of the GH-responsive markers. Serum IGF-I, IGFBP-3, and ALS were all lower (P < 0.05), whereas the collagen markers PINP, ICTP, and PIIINP were higher (P < 0.05) in men than in women. Multiple regression analysis indicated that age, gender, BMI, and ethnicity accounted for 23–54% of total between-subject variability of the markers. Age and gender cumulatively accounted for 91% of the attributable variation of IGF-I and more than 80% for PINP, ICTP, and PIIINP. Gender exerted the greatest effect on ALS (48%), and BMI accounted for less than 12% attributable variation for all markers. The influence of ethnicity was greatest for IGFBP-3 and ALS; however, for the other markers, it accounted for less than 6% attributable variation. Analysis of 995 athletes indicated that sporting type contributed 5–19% of attributable variation. Conclusions: Age and gender were major determinants of variability of GH-responsive markers except for IGFBP-3 and ALS. Ethnicity is unlikely to confound the validity of a GH doping test based on IGF-I and these collagen markers.
ISSN:0021-972X
1945-7197
DOI:10.1210/jc.2006-0612