Usefulness of Growth Hormone (GH) Stimulation Tests and IGF-1 Concentration Measurement in GH Deficiency Diagnosis
-
Monika Obara-Moszynska
,
Andrzej Kctdzia
Abstract
The diagnosis of growth hormone (GH) deficiency (GHD) is still problematic for the clinician. There is no gold standard for estimating GH secretion. The aim of this study was to compare the diagnostic usefulness of spontaneous GH secretion test, pharmacological tests with insulin, clonidine, L-dopa, and glucagon, and IGF-1 measurement in GHD. We studied 180 prepubertal, short children. Predictive values were calculated for different GH cutoff levels for each diagnostic test. ROC curves were used to estimate the diagnostic usefulness of the tests. The results show that sleep is the strongest stimulatory agent for GH secretion. The estimation of GH secretion after onset of sleep can be used as a screening test in GHD diagnosis. The insulin test has the highest discrimination. A combination of insulin test with another provocative test allows high discrimination and accuracy for standard cut-off GH level. Measurement of IGF -I is characterized by low predictive values. IGF-1 level below the mean according to age indicates high probability of GHD. Auxological parameters should be the most important factor in diagnosing GHD.
© 2020 by Walter de Gruyter Berlin/Boston
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Articles in the same Issue
- TITLE
- TABLE OF CONTENTS
- EDITORIAL. Why the Consensus for Consensus?
- REVIEW. Translating Transition: A Critical Review of the Diabetes Literature
- SOCIETY NEWS. VanWyk Award Acceptance Speech, May 5, 2008
- IMAGES IN PEDIATRIC ENDOCRINOLOGY. Pseudopuberty and Juvenile Hypothyroidism
- ORIGINAL CONTRIBUTIONS
- Long-term Follow-up of Patients with Congenital Hyperinsulinism in Austria
- An Analysis of Predictive Factors for the Conversion from Premature Thelarche into Complete Central Precocious Puberty
- Propylthiouracil Associated Antineutrophil Cytoplasmic Antibodies (ANCA) in Patients with Childhood Onset Graves' Disease
- Molecular Analysis of the AR and SRD5A2 Genes in Patients with 46,XY Disorders of Sex Development
- Efficacy and Safety of Inhaled Human Insulin (Exu hera®) Compared to Subcutaneous Insulin in Children Ages 6 to 11 Years with Type 1 Diabetes Mellitus: Results of a 3-Month, Randomized, Parallel Trial
- Usefulness of Growth Hormone (GH) Stimulation Tests and IGF-1 Concentration Measurement in GH Deficiency Diagnosis
- Hyperglycemia and Hypoinsulinemia in Patients with Fanconi-Bickel Syndrome
- PATIENT REPORT LETTERS
- Glycogen Storage Disease Type Ilia Presenting as Non-Ketotic Hypoglycemia: Use of a Newly Approved Commercially Available Mutation Analysis to Non-Invasively Confirm the Diagnosis
- Clinical and Laboratory Findings of Two Newborns with Wiedemann-Rautenstrauch Syndrome: Additional Features, Evaluation of Bone Turnover and Review of the Literature
- Congenital Nephrotic Syndrome and Persistent Hypothyroidism After Bilateral Nephrectomy
- LETTER TO THE EDITOR
- Re: Relationship between endothelial dysfunction, carotid artery intima media thickness and circulating markers of vascular inflammation in obese hypertensive children and adolescents (J Pediatr Endocrinol Metab 2007; 20: 1125-1136)
- The Incidence of Glucose Disorders Related to Cystic Fibrosis Could Be Higher with Current Criteria (Re: Carbohydrate Metabolism Changes in Cystic Fibrosis. J Pediatr Endocrinol Metab 2007; 20: 621-663)
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