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Updated: Aug 17, 2026
Comparative Analysis of Human Growth Hormone in Serum Using SPRi, Nano-SPRi and ELISA Assays
Published on: January 7, 2016
What is a normal stimulated growth hormone concentration?
M T Dattani1, P J Pringle, P C Hindmarsh
1Endocrine Unit, Middlesex Hospital, London, U.K.
Insights
This study determined optimal cut-off values for diagnosing growth hormone (GH) insufficiency in short children using the insulin tolerance test. A peak serum GH concentration of 13.5 mU/l showed the best diagnostic performance in their assay.
Area of Science:
- Pediatric Endocrinology
- Growth Hormone Disorders
- Diagnostic Testing
Background:
- Short stature in children necessitates accurate diagnosis of growth hormone (GH) insufficiency.
- The insulin tolerance test (ITT) is a common method to assess GH secretion.
- Establishing reliable diagnostic criteria is crucial for timely intervention.
Purpose of the Study:
- To determine optimal "cut-off" values for serum GH concentration following ITT in short prepubertal children.
- To correlate GH response to ITT with individual growth rates (height velocity SDS).
- To evaluate the efficiency, sensitivity, and specificity of the ITT for diagnosing GH insufficiency.
Main Methods:
- Retrospective analysis of 148 short prepubertal children (aged 3.9-11.9 years).
- Comparison of serum GH concentration response to ITT with height velocity standard deviation scores (SDS).
- Calculation of diagnostic performance metrics (efficiency, sensitivity, specificity) at various GH cut-off levels.
Main Results:
- Children with height velocity SDS > -0.8 (Group 1) had significantly higher median peak GH responses (19.9 mU/l) than Group 2 (SDS < -0.8, 9.9 mU/l).
- A cut-off value of 13.5 mU/l in the Hybritech assay yielded optimal efficiency (66%), sensitivity (64%), and specificity (70%).
- The relationship between GH response and growth rate was continuous, not discrete.
Conclusions:
- A serum GH cut-off of 13.5 mU/l demonstrated good diagnostic utility in this cohort.
- Individual laboratories should establish their own "normal" cut-off values based on their specific GH assay.
- The study highlights the continuous nature of GH response in relation to growth velocity.
Abstract:
In a retrospective analysis, we have compared the response of serum GH concentration to insulin-induced hypoglycaemia in 148 short prepubertal children (114 males, 34 females) aged between 3.9 and 11.9 years with the growth rate of the individual to determine 'cut-off' values for the diagnosis of GH insufficiency. Sixty-three children grew with a height velocity standard deviation score (SDS) greater than -0.8 (group 1), which represents the growth velocity of children progressing along or closely parallel to the third height centile. Eighty-five children had a height velocity SDS of less than -0.8 (group 2). Median peak serum GH concentration responses to insulin-induced hypoglycaemia were 19.9 mU/l (range 1.5-54.4) in group 1 and 9.9 mU/l (range 0.7-46.2) in group 2 (Mann-Whitney; P less than 0.001). Using growth rate as the determinant of normality, the efficiency, sensitivity and specificity of the insulin-induced hypoglycaemia test were calculated using different serum GH concentration cut-off values to diagnose GH insufficiency. In our (Hybritech) assay, a cut-off value of 13.5 mU/l provided optimal performance in terms of efficiency (66%), sensitivity (64%) and specificity (70%). The response of serum GH concentration to insulin-induced hypoglycaemia in short children growing at different growth rates was continuous. Each laboratory measuring serum GH concentrations needs to construct its own 'normal' cut-off value.
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