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Clinical usefulness of urinary growth hormone measurement in short children
T Tanaka1, A Yoshizawa, Y Miki
1Department of Endocrinology and Metabolism, National Children's Hospital, Tokyo, Japan.
Insights
Urinary growth hormone (GH) levels can reflect spontaneous GH secretion and help screen short children for GH treatment. Measuring nocturnal urinary GH may identify children with GH insufficiency for potential treatment.
Area of Science:
- Pediatric Endocrinology
- Biochemistry
Background:
- Assessing growth hormone (GH) secretion is crucial for diagnosing short stature in children.
- Current diagnostic methods can be invasive and time-consuming.
Purpose of the Study:
- To evaluate nocturnal urinary GH levels as a non-invasive marker for spontaneous GH secretion.
- To determine the utility of urinary GH in screening short children for GH therapy.
Main Methods:
- Measured nocturnal urinary GH in 96 short children and 73 normal children.
- Correlated urinary GH with renal function markers (albumin, beta 2-microglobulin).
- Compared urinary GH with serum GH and IGF-I levels.
Main Results:
- Nocturnal urinary GH correlated positively with serum GH and IGF-I, indicating reflection of GH secretion.
- Urinary GH was significantly lower in children with complete GH deficiency.
- A cutoff of 5 ng/g creatinine identified 87.5% of short children with GH insufficiency suitable for treatment.
Conclusions:
- Nocturnal urinary GH is a potential non-invasive biomarker for assessing GH secretion in children.
- Urinary GH measurement may aid in screening short children for GH deficiency and guiding treatment decisions.
Abstract:
Growth hormone (GH) levels in nocturnal urine were measured in 96 short children and 73 children of normal height in order to investigate whether urinary GH levels reflect spontaneous GH secretion and whether they might be used to screen short children for GH treatment. GH levels in 24-hour urine samples were significantly correlated with urinary albumin and beta 2-microglobulin levels in normal children, demonstrating an influence of renal function on urinary GH measurements. Nocturnal urinary GH levels showed significant positive correlations with mean serum GH levels during 3 hours of sleep (r = 0.26, p less than 0.05) and plasma insulin-like growth factor I (IGF-I) levels, reflecting physiological GH secretion. Urinary GH levels were significantly lower in the eight children with complete GH deficiency (3.1 +/- 2.3 ng/g creatinine) than in the normal children (13.8 +/- 11.2 ng/g creatinine). Urinary GH levels in three other groups of short children, partial GH deficiency (11.1 +/- 16.9 ng/g creatinine), impaired GH secretion during sleep (10.4 +/- 12.6 ng/g creatinine) and non-endocrine short stature (18.8 +/- 19.5 ng/g creatinine), were not significantly different from those in the normal children. However, when the cut-off point for defining GH insufficiency was set at 5 ng/g creatinine, 87.5% (21 out of 24) of the short children with low urinary GH levels were suitable subjects for GH treatment (i.e. had complete GH deficiency, partial GH deficiency or impaired GH secretion during sleep).(ABSTRACT TRUNCATED AT 250 WORDS)