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Assessing short-statured children for growth hormone deficiency
W Chemaitilly1, C Trivin, J-C Souberbielle
1Université René-Descartes and Pediatric Endocrinology Unit, Hôpital Necker-Enfants-Malades, Assistance Publique-Hôpitaux de Paris, France.
Hormone Research
|June 7, 2003
Summary
Measuring growth hormone (GH) during sleep and priming boys with testosterone can help diagnose GH deficiency in short children. Further imaging is needed for suspected anatomical issues.
Area of Science:
- Pediatric Endocrinology
- Growth Disorders
Background:
- Short stature in children often necessitates evaluation for growth hormone (GH) deficiency.
- Accurate diagnosis is crucial for timely intervention and optimal growth outcomes.
Purpose of the Study:
- To identify the most effective diagnostic tools for growth hormone (GH) deficiency in short-statured children.
- To optimize the diagnostic workup for pediatric GH deficiency.
Main Methods:
- Patients were categorized into prepubertal (n=113) and pubertal (n=112) groups.
- Measurements included mean plasma GH during sleep, peak GH after provocative testing, and insulin-like growth factor I (IGF-I).
- Pubertal boys received testosterone priming (n=25).
Main Results:
- Mean GH during sleep was more frequently normal than peak GH or IGF-I.
- In prepubertal children, mean sleep GH correlated positively with height, growth rate, peak GH, and IGF-I.
- In pubertal children, mean sleep GH correlated positively with peak GH and IGF-I.
- Testosterone priming improved the normality rate of GH and IGF-I measurements.
- Patients with pituitary stalk interruption consistently showed low IGF-I.
Conclusions:
- Mean GH concentration during sleep and testosterone priming in boys can aid in excluding idiopathic GH deficiency.
- Magnetic resonance imaging is essential for identifying anatomical abnormalities when GH and/or IGF-I levels are low.