ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Pediatric Endocrinology
Serum Osteocalcin as a Novel Biomarker for Differentiating Growth Hormone Deficiency from Idiopathic Short Stature
Provisionally accepted
Yuling Wang1*
Huanzhen Zhou1
Hongye Wang2Jianying Ma1Xingyu Chen1Hongmei Yang1Hongcun Zheng1Aiping Wang1*- 1Kunming First People's Hospital North and South Branches, Kunming, China
- 2Dali University, Dali, China
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Abstract Background:The differentiation between Growth Hormone Deficiency (GHD) and Idiopathic Short Stature (ISS) primarily relies on the growth hormone stimulation test (GHST),which is invasive and can cause adverse effects. Objective :To evaluate the diagnostic value of bone metabolism markers in distinguishing GHD from ISS. Methods:A cross-sectional study was conducted, enrolling 76 children aged 3–11 years with short stature (37 in the GHD group and 39 in the ISS group). Clinical data including height, weight, bone age, Insulin-like Growth Factor 1(IGF-1), and Peak Growth Hormone (GHP) levels were collected. Eight bone metabolism markers were measured: Osteocalcin (OC), β-C-terminal telopeptide of type I collagen (β-CTX), 25-Hydroxyvitamin D (25(OH)D), Vitamin D (VitD), Alkaline Phosphatase (ALP), Parathyroid Hormone (PTH), serum Calcium (Ca), and serum Phosphorus (P). Nonparametric tests were used for intergroup comparisons. Logistic regression and Receiver Operating Characteristic (ROC) curve analyses were performed to assess diagnostic efficacy, and Spearman correlation analysis was employed for correlation evaluation. Results:The OC level in the GHD group was significantly lower than that in the ISS group (P < 0.001), while serum P was higher in the GHD group (P < 0.05). Multivariate analysis identified OC as an independent discriminative factor (OR = 182.585, P < 0.001). ROC curve analysis revealed that OC had an area under the curve (AUC) of 0.949, At a cutoff of 1.026 ng/mL, sensitivity was 86.49% and specificity was 100%. Correlation analysis indicated a positive association between OC levels and GHP (r = 0.6, P < 0.05). Conclusion:Serum OC shows high diagnostic value for distinguishing GHD from ISS, demonstrating significant clinical utility.
Keywords: Bone TurnoverMarkers, Diagnostic Markers, growth hormone deficiency, idiopathic short stature, Osteocalcin
Received: 13 Nov 2025; Accepted: 11 Feb 2026.
Copyright: © 2026 Wang, Zhou, Wang, Ma, Chen, Yang, Zheng and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yuling Wang
Aiping Wang
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