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[Diagnosis of growth hormone deficiency with the growth hormone releasing factor GRF 1-40. The potentials and limits]
Insights
Growth hormone-releasing factor (GRF) effectively stimulated human growth hormone (HGH) in patients with delayed development but showed limited efficacy in those with idiopathic growth hormone deficiency or craniopharyngeoma, aiding in diagnosis.
Area of Science:
- Endocrinology
- Pediatric Endocrinology
Context:
- Growth hormone (GH) deficiency is a critical condition affecting child development.
- Accurate diagnosis of GH deficiency is essential for timely intervention.
- Growth hormone-releasing factor (GRF) is a potential diagnostic tool.
Purpose:
- To evaluate the efficacy of growth hormone-releasing factor (GRF 1-40) as a diagnostic agent for growth hormone deficiency (GHD).
- To compare GRF-induced human growth hormone (HGH) stimulation in patients with constitutionally delayed development (CDD) versus those with idiopathic GHD or craniopharyngeoma.
Summary:
- Eleven patients with CDD, seven with idiopathic GHD, and ten with craniopharyngeoma received GRF 1-40 (1 microgram/kg).
- Patients with CDD exhibited significantly higher HGH responses (mean max 86.7 microU/ml at 30 min) compared to conventional methods.
- Patients with idiopathic GHD or craniopharyngeoma showed minimal HGH rise, with only two craniopharyngeoma patients meeting conventional stimulation criteria.
Impact:
- GRF 1-40 demonstrates superior HGH stimulation in CDD compared to other methods.
- The limited response to GRF in idiopathic GHD and craniopharyngeoma aids in differentiating these conditions.
- GRF stimulation, combined with somatomedin C levels, can assist in diagnosing growth hormone deficiency.
Abstract:
Eleven patients with constitutionally delayed development, seven patients with idiopathic growth hormone deficiency and ten patients with craniopharyngeoma received growth hormone releasing factor GRF 1-40 in a dose of 1 micrograms/kg body weight as a bolus injection. In the patients with constitutionally delayed development, a mean maximum HGH value of 86.7 microU/ml was measured 30 minutes after GRF injection. Considerably higher HGH stimulation values were thus obtained after GRF than with conventional stimulation methods. In the patients with idiopathic growth hormone deficiency or craniopharyngeoma, there was mostly only a slight rise of the growth hormone level with a delayed onset. Merely two patients with craniopharyngeoma could be adequately stimulated in accordance with conventional criteria (HGH greater than 12 microU/ml), although their values also remained markedly below those of the patients with constitutionally delayed development. Both patients had somatomedin C values which were below that normal for their age; together with the delayed rise in HGH after GRF, this allowed diagnosis of growth hormone deficiency.