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Urinary growth hormone excretion as a screening test for growth hormone deficiency
J M Walker1, P J Wood, S Williamson
1Department of Paediatrics, Southampton General Hospital.
Insights
Measuring overnight urinary growth hormone secretion can help identify growth hormone deficiency in children. This simple urine test may serve as a valuable screening tool for pediatric short stature.
Area of Science:
- Pediatric Endocrinology
- Biochemical Diagnostics
Background:
- Growth hormone (GH) is crucial for childhood growth.
- Accurate assessment of GH secretion is vital for diagnosing short stature.
- Conventional provocative testing can be invasive and time-consuming.
Purpose of the Study:
- To evaluate overnight urinary GH secretion as a potential screening tool for GH deficiency in prepubertal children.
- To establish a reference range for urinary GH in healthy prepubertal children.
- To correlate urinary GH levels with provocative testing results.
Main Methods:
- Overnight urinary GH was measured using an immunoradiometric assay in 41 normal prepubertal children across three age groups.
- Urinary GH was also assayed in 49 children investigated for short stature.
- Results were compared with conventional provocative testing.
Main Results:
- A prepubertal reference range for overnight urinary GH was established as 2.25-10.50 microU/night.
- Children with confirmed GH deficiency exhibited significantly lower urinary GH levels.
- A strong correlation was observed between overnight urinary GH and peak serum GH response to provocation.
Conclusions:
- Overnight urinary GH measurement is a potentially useful, non-invasive screening test for GH deficiency in children.
- This assay may help identify children requiring further investigation for short stature.
- The findings support the utility of urinary GH as a diagnostic biomarker.
Abstract:
Overnight urinary growth hormone secretion was measured by an immunoradiometric assay incorporating commercially available reagents, in 41 normal prepubertal school-children from three age groups: 3-5 years, 6-7 years, and 9-10 years. There was no significant difference between the groups expressing the results as total microU/specimen and so they have been combined to provide a prepubertal reference range of 2.25-10.50 microU/night. Prepubertal children with growth hormone deficiency who had not been receiving growth hormone treatment for two days had overnight urinary growth hormone concentrations well below this range. Urinary growth hormone was assayed in 49 children undergoing investigation for short stature with conventional provocative testing, and those shown to have growth hormone deficiency had correspondingly low overnight urinary growth hormone concentrations. There was, in addition, a strong correlation between overnight urinary growth hormone concentrations and peak serum response to provocation. This simple urine assay may provide a useful screening test for growth hormone deficiency.