Insulin-like Growth Factor-binding Protein 3 (IGFBP-3)

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Turnaround Time: 1 - 3 days
CPT Code:


Test Type: 1 mL Serum
Stability Time:



Room temperature

14 days


14 days


90 days

Freeze/thaw cycles

Stable x3

Reference Range:

See table.1

Insulin-like Growth Factor-binding Protein-3 (IGFBP-3)


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Male (μg/L)

Female (μg/L)

0 to 11 m



1 y



2 y



3 y



4 y



5 y



6 y



7 y



8 y



9 y



10 y



11 y



12 y



13 y



The insulin-like growth factor (IGF) system plays a critical role in the growth and differentiation of normal and malignant cells. The components of the IGF system include growth hormone (GH), IGF-I and II, type I and II receptors, IGF binding proteins and proteases. IGF binding proteins were first identified for their high affinity interactions with IGF-I and IGF-II.2

IGFBP-3 is the most abundant IGFBP species in circulation and binds 75% to 90% of circulating IGF-I in a ternary complex consisting of IGFBP-3, IGF-I and acid-labile subunit (ALS). IGFBP-3 modulates the activity of IGF-1 and to increase their half lives. It has been postulated that IGFBP-3 is regulated by GH and originates in the liver as low levels were observed in patients with impaired hepatic function.3

IGFBP-3 has historically been used in the investigation of growth hormone deficiency, acromegaly, hypopituitarism and to monitor recombinant GH therapy.4,5 IGFBP-3 is known to modulate the actions of IGFs in circulation as and at the IGF-1 receptor.3 IGFBP-3 has also been shown to exhibit distinct biological effects independent of the IGF/IGF-1 receptor axis.6,7 Recent studies have impaired interaction of IGFBP-3 with a variety of proteins or signaling cascades critical to cell cycle control and apoptosis; however, the actual mechanism of IGFBP-3 action is unclear.6

Several factors influence IGFBP-3 levels, including age, sexual development, nutrition, and hepatic and renal function. IGFBP-3 increases during early childhood and puberty and then decreases slightly in adult life. Levels of this binding protein decrease during fasting and chronic malnutrition. IGFBP-3 levels are decreased in hepatic failure and diabetes mellitus, but are increased in chronic renal failure.

1. Friedrich N, Wolthers OD, Arafat AM, et al. Age- and sex-specific reference intervals across life span for insulin-like growth factor binding protein 3 (IGFBP-3) and the IGF-1 to IGFBP-3 ratio measured by new automated chemiluminescence assays. J Clin Endocrinol Metab. 2014 May; 99(5):1675-1686. PubMed 24483154

2. Ballard J, Baxter R, Binoux M, et al. On the nomenclature of the IGF binding proteins. Acta Endocrinol (Copenh). 1989 Nov; 121(5):751-752. PubMed 2555997

3. Holly JM, Perks CM. Insulin-like growth factor physiology: What we have learned from human studies. Endocrinol Metab Clin North Am. 2012 Jun; 41(2):249-263. PubMed 22682629 4. Blum WF, Ranke MB. Use of insulin-like growth factor binding protein 3 for the evaluation of growth disorders. Horm Res. 990; 33(Suppl 4):31-37. PubMed 1700965

5. Ranke MB, Schweizer R, Elmlinger MW, et al. Significance of basal IGF-I, IGFBP-3 and IGFBP-2. measurements in the diagnostics of short stature in children. Horm Res. 2000; 54(2):60-68. PubMed 11251368

6. Jogie-Brahim S, Feldman D, Oh Y. Unraveling insulin-like growth factor binding protein-3 actions in human disease. Endocr Rev. 2009 Aug; 30(5):417-437. PubMed 19477944

7. Mohan S, Baylink DJ. IGF-binding proteins are multifunctional and act via IGF-dependent and -independent mechanisms. J Endocrinol. 2002 Oct; 175(1):19-31. PubMed 12379487

Baxter RC, Martin JL. Radioimmunoassay of growth hormone-dependent insulin-like growth factor binding protein in human plasma. J Clin Invest. 1986 Dec; 78(6):1504-1512. PubMed 2431001

Blum WF, Ranke MB, Kietzmann K, Gauggel E, Zeisel HJ, Bierich JR. A specific radioimmunoassay for the growth hormone (GH)-dependent somatomedin-binding protein: Its use for diagnosis of GH deficiency. J Clin Endocrinol Metab. 1990 May; 70(5):1292-1298. PubMed 1692331

Insulin-like Growth Factor Binding Protein-3 on the IDS iSYS, Device Code IS-4400, IFU Version 2011-11-29 V03. Fountain Hills, Ariz:Immunodiagnostic Systems Inc (IDS Inc). Rosenfeld RG,

Wilson DM, Lee PD, Hintz RL.. Insulin-like growth factors I and II in evaluation of growth retardation. J Pediatr. 1986 Sep; 109(3):428-433. PubMed 3746530

Collection Details:

Collection Instructions:

This test may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H, or coenzyme R). It is recommended to ask all patients who may be indicated for this test about biotin supplementation. Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample.

Red-top tube or gel-barrier tube.

If a red-top tube is used, transfer separated serum to a plastic container.


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