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Related Experiment Videos

Provocative tests for growth hormone release.

W J Tze, H J Guyda, P Hoy

    The Journal of Pediatrics
    |April 1, 1976
    PubMed
    Summary
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    Diagnosing growth hormone deficiency requires multiple tests. Some children with short stature may show subnormal growth hormone responses but still not benefit from growth hormone therapy.

    Area of Science:

    • Pediatric Endocrinology
    • Growth Hormone Physiology
    • Diagnostic Testing

    Background:

    • Short stature in children can have various causes, including growth hormone (GH) deficiency.
    • Standard provocative tests like insulin tolerance test (ITT) and arginine infusion test (AIT) are used to assess GH secretion.
    • Interpreting subnormal GH responses requires careful consideration of individual growth patterns and potential confounding factors.

    Purpose of the Study:

    • To evaluate the necessity of multiple provocative tests for diagnosing growth hormone deficiency in children with short stature.
    • To determine if children with subnormal GH responses to ITT and AIT would benefit from GH therapy.
    • To investigate the impact of sex steroid pretreatment on GH provocative testing.

    Main Methods:

    Related Experiment Videos

  • Five prepubertal males (10-14 years) with short stature, normal growth rates, and bone ages underwent multiple GH stimulation tests.
  • Initial tests included insulin-induced hypoglycemia and arginine infusion.
  • Subsequent tests involved glucagon stimulation, tolbutamide-induced hypoglycemia, and repeat ITT/AIT after sex steroid pretreatment.

    • Main Results:

    • All five subjects exhibited subnormal peak GH responses (≤5 ng/ml) to initial ITT and AIT.
    • Four out of five subjects demonstrated at least one normal GH response to subsequent provocative tests.
    • Two subjects previously treated with GH for six months showed no characteristic growth response of GH deficiency.

    Conclusions:

    • Subnormal GH response to single provocative tests does not definitively confirm GH deficiency or predict response to GH therapy.
    • Multiple provocative GH testing is crucial for accurate diagnosis and to identify children unlikely to benefit from GH therapy.
    • Sex steroid pretreatment may enhance GH release in some children, aiding in test interpretation.