Journal Mobile Options
Table of Contents
Vol. 60, No. 1, 2003
Issue release date: 2003
Horm Res 2003;60:34–42
(DOI:10.1159/000070825)

Assessing Short-Statured Children for Growth Hormone Deficiency

Chemaitilly W. · Trivin C. · Souberbielle J.-C. · Brauner R.
To view the fulltext, log in and/or choose pay-per-view option

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

Aim: To optimize the workup of short-statured children by defining the most appropriate tools for diagnosing growth hormone (GH) deficiency. Methods: Patients were assigned to prepubertal (n = 113) or pubertal (n = 112, including 25 boys primed with testosterone) age groups. Mean plasma GH concentration during sleep, GH peak after provocative test, and insulin-like growth factor I (IGF-I) were measured in a single evaluation. Results: The mean GH concentration during sleep was more often normal (n = 155) than the GH peak after provocative tests (n = 105) or the IGF-I concentration (n = 88). Prepubertal patients with a normal body mass index (BMI) had mean GH concentrations during sleep that correlated positively with height, growth rate, GH peak after provocative tests, and IGF-I (p < 0.0005 for all) and negatively with the difference between target and patient heights (p = 0.01) and BMI (p < 0.05). Pubertal patients with a normal BMI had a mean GH concentration during sleep that correlated positively with GH after provocative tests (p < 0.0001) and IGF-I (p < 0.005). Mean GH concentration during sleep and IGF-I concentration for boys primed with testosterone were more often normal (n = 23) than the GH peak after provocative tests (n = 14). All 9 patients with pituitary stalk interruption had low IGF-I concentrations; 1 patient had a normal GH peak after provocative test, and 2 patients had normal mean GH concentrations during sleep. Conclusions: Measuring the GH concentration during sleep and priming boys with pubertal delay can help to exclude idiopathic GH deficiency. Magnetic resonance imaging is needed to exclude anatomic abnormalities when GH and/or IGF-I concentrations are low.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Adan L, Trivin C, Sainte-Rose C, Zucker JM, Hartmann O, Brauner R: Growth hormone deficiency caused by cranial irradiation during childhood: Factors and markers in young adults. J Clin Endocrinol Metab 2001;86:5245–5251.
  2. Rosenfeld R, Albertsson-Wikland K, Cassorla F, Frasier SD, Hasegawa Y, Hintz L, Lafranchi S, Lippe B, Loriaux L, Melmed S, Preece M, Ranke M, Reiter E, Rogol A, Underwood L, Werther G: Diagnostic controversy: The diagnosis of childhood growth deficiency revisited. J Clin Endocrinol Metab 1995;80:1532–1540.
  3. Cacciari E, Tessoni P, Cicognani A, Pirazzoli P, Salardi S, Balsamo A, Cassio A, Zucchini S, Colli C, Tassinari D, Tani G, Gualandi S: Value and limits of pharmacological and physiological tests to diagnose growth hormone (GH) deficiency and predict therapy response: First and second retesting during replacement therapy of patients defined as GH deficient. J Clin Endocrinol Metab 1994;79:1663–1669.
  4. Rosenfeld R: Is growth hormone deficiency a viable diagnosis? J Clin Endocrinol Metab 1997;82:349–351.
  5. Adan L, Souberbielle JC, Brauner R: Diagnostic markers of permanent idiopathic growth hormone deficiency. J Clin Endocrinol Metab 1994;78:353–358.
  6. Argyropoulou M, Pérignon F, Brauner R, Brunelle F: Magnetic resonance imaging in the diagnosis of growth hormone deficiency. J Pediatr 1992;120:886–891.
  7. Castro C, Trivin C, Souberbielle JC, Zerah M, Brauner R: Growth hormone deficiency: Permanence and diagnosis in young adults. Horm Res 2002;58:165–171.
  8. Juul A, Kastrup KW, Pedersen SA, Skakkebaek NE: Growth Hormone (GH) provocative retesting of 108 young adults with childhood-onset GH deficiency and the diagnostic value of insulin-like growth factor 1 and IGF-binding protein-3. J Clin Endocrinol Metab 1997;82:1195–1201.
  9. Maghnie M, Strigazzi C, Tinelli C, Autelli M, Cisternino M, Loche S, Severi F: Growth hormone (GH) deficiency (GHD) of childhood-onset: Reassessment of GH status and evaluation of the predictive criteria for permanent GHD in young adults. J Clin Endocrinol Metab 1999;84:1324–1328.
  10. Nicolson A, Toogood A, Rahmia A, Shalet S: The prevalence of severe growth hormone deficiency in adults who received growth hormone replacement in childhood. Clin Endocrinol (Oxf) 1996;44:311–316.
  11. Tauber M, Moulin P, Pienkowski C, Jouret B, Rochiccioli P: Growth hormone (GH) retesting and auxological data in 131 GH-deficient patients after completion of treatment. J Clin Endocrinol Metab 1997;82:352–356.
  12. Wacharasindhu S, Cotterill AM, Camacho-Hubner C, Besser GM, Savage MO: Normal growth hormone secretion in growth hormone insufficient children retested after completion of linear growth. Clin Endocrinol (Oxf) 1996;45:553–556.
  13. Reiter E, Martha P Jr: Pharmacological testing of growth hormone secretion. Horm Res 1990;33:121–127.
  14. Tassoni P, Cacciari E, Cau M, Colli C, Tosi M, Zucchini S, Cigognani A, Piazzoli P, Salardi S, Balsamo A, Frejaville E, Cassio A, Zappulla F: Variability of growth hormone response to pharmacological and sleep tests performed twice in short children. J Clin Endocrinol Metab 1990;71:230–234.
  15. Oerter K, Sobel A, Rose S, Cristiano A, Malley J, Cutler G, Baron J: Combining insulin-like growth factor 1 and mean spontaneous nighttime growth hormone levels for the diagnosis of growth hormone deficiency. J Clin Endocrinol Metab 1992;75:1413–1420.
  16. Donaldson D, Pan F, Hollowell J, Stevenson J, Gifford R, Moore W: Reliability of stimulated and spontaneous growth hormone (GH) levels for identifying the child with low GH secretion. J Clin Endocrinol Metab 1991;72:647–652.
  17. GH Research Society: Consensus guidelines for the diagnosis and treatment of growth hormone (GH) deficiency in childhood and adolescence: Summary statement of the GH Research Society. J Clin Endocrinol Metab 2000;85:3990–3993.
  18. Adan L, Souberbielle JC, Brauner R: Management of the short stature due to pubertal delay in boys. J Clin Endocrinol Metab 1994;78:478–482.
  19. Sempe M, Pedron G, Roy-Pernot MP: Auxologie, méthode et séquence. Paris, Théraplix, 1979.
  20. Rolland-Cachera MF, Cole TJ, Sempé M, Trichet J, Rossignol C, Charrand A: Body mass index variations: Centiles from birth to 87 years. Eur J Clin Nutr 1991;45:13–21.
  21. Ayatollahi SM: Age standardization of weight for height in children using a unified z score method. Ann Hum Biol 1995;22:151–162.
  22. Tanner JM, Goldstein H, Whitehouse RH: Standards for children’s height at ages 2–9 years allowing for height of parents. Arch Dis Child 1970;47:755–762.
  23. Greulich W, Pyle S: Radiographic Atlas of Skeletal Development of the Hand and Wrist, ed 2. Stanford, Stanford University Press, 1959.
  24. Bussières L, Souberbielle JC, Pinto G, Adan L, Noël M, Brauner R: The use of insulin-like growth factor 1 reference values for the diagnosis of growth hormone deficiency in prepubertal children. Clin Endocrinol (Oxf) 2000;52:735–739.
  25. Richards GE, Cavallo A, Meyer WJ 3rd: Diagnostic validity of 12-hour integrated concentration of growth hormone. Am J Dis Child 1987;141:553–555.
  26. Spiliotis B, August G, Hung W, Sonis W, Mendelson W, Bercu B: Growth hormone neurosecretory dysfunction, a treatable cause of short stature. JAMA 1984;251:2223–2230.
  27. Rose S, Ross L, Uriarte M, Barnes K, Cassorla F, Cutler G: The advantage of measuring stimulated as compared with spontaneous growth hormone levels in the diagnosis of growth hormone deficiency. N Engl J Med 1988;319:201–207.
  28. Bercu B: Disorders of growth hormone neurosecretion; in Lifshitz L (ed): Pediatric Endocrinology, ed 3. New York, Marcel Dekker, 1996, pp 45–59.
  29. Gonc EN, Yordam N, Kandemir N, Alikasifo&gcaron;lu A: Comparison of stimulated growth hormone levels in primed versus unprimed provocative tests: Effect of various testosterone doses on growth hormone levels. Horm Res 2001;56:32–37.
  30. Marin G, Domene H, Barnes K, Blackwell B, Cassorla F, Cutler G: The effects of estrogen priming and puberty on the growth hormone response to standardized treadmill exercise and arginine-insulin in normal girls and boys. J Clin Endocrinol Metab 1994;79:537–541.
  31. Martinez AS, Domene HM, Ropelato MG, Jasper HG, Pennisi PA, Escobar ME, Heinrich JJ: Estrogen priming effect on growth hormone (GH) provocative test: A useful tool for the diagnosis of GH deficiency. J Clin Endocrinol Metab 2000;85:4168–4172.
  32. Mazur T, Clopper R: Pubertal disorders: Psychology and clinical management. Endocrinol Metab Clin North Am 1991;20:211–230.
  33. Sizonenko PC, Clayton PE, Cohen P, Hintz RL, Tanaka T, Laron Z: Diagnosis and management of growth hormone deficiency in childhood and adolescence. 1. Diagnosis of growth hormone deficiency. Growth Horm IGF Res 2001;11:137–165.
  34. Tanaka T, Cohen P, Clayton PE, Laron Z, Hintz RL, Sizonenko PC: Diagnosis and management of growth hormone deficiency in childhood and adolescence. 2. Growth hormone treatment in growth hormone deficient children. Growth Horm IGF Res 2002;12:323–341.
  35. Pinto G, Adan L, Souberbielle JC, Thalassinos C, Brunelle F, Brauner R: Idiopathic growth hormone deficiency: Presentation, diagnostic and treatment during childhood. Ann Endocrinol (Paris) 1999;60:224–231.
  36. Pinto G, Netchine I, Sobrier ML, Brunelle F, Souberbielle JC, Brauner R: Pituitary stalk interruption syndrome: A clinical-biological-genetic assessment of its pathogenesis. J Clin Endocrinol Metab 1997;82:3450–3454.


Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50