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Quantitation of urinary growth hormone in children with normal and abnormal growth
C H Albini1, T Quattrin, R L Vandlen
1Department of Pediatrics, Children's Hospital of Buffalo, New York.
Insights
Urinary growth hormone (GH) excretion measurements offer a simple, noninvasive method for screening. This test can help identify children with GH deficiency or excess, aiding in diagnosis and treatment.
Area of Science:
- Endocrinology
- Pediatric Endocrinology
- Clinical Chemistry
Background:
- Growth hormone (GH) is crucial for growth and metabolism.
- Accurate assessment of GH status is vital for diagnosing endocrine disorders.
- Current diagnostic methods can be invasive or complex.
Purpose of the Study:
- To evaluate the utility of urinary growth hormone (GH) excretion as a noninvasive screening tool.
- To compare urinary GH levels in children with GH deficiency, idiopathic growth failure, and healthy controls.
- To assess urinary GH excretion in acromegaly and after GH administration.
Main Methods:
- Quantification of urinary GH in 12-h overnight collections from control children, GH-deficient children, and children with idiopathic growth failure.
- Confirmation of urinary GH authenticity using high-performance liquid chromatography and immunoassays.
- Measurement of urinary GH in an acromegalic patient and in hypopituitary patients post-GH administration.
Main Results:
- Urinary GH excretion was significantly lower in GH-deficient and idiopathic growth failure groups compared to controls.
- Approximately 50% of children with idiopathic growth failure showed urinary GH levels similar to GH-deficient individuals.
- Elevated urinary GH was observed in an acromegalic patient, and post-GH administration levels increased in hypopituitary patients.
Conclusions:
- Urinary GH measurement is a potentially useful, simple, and noninvasive screening test.
- This method may aid in identifying patients with GH deficiency or excess.
- Further validation could establish urinary GH as a valuable diagnostic adjunct.
Abstract:
Urinary growth hormone (GH) excretion was quantitated in 12-h overnight urine collections obtained from 31 control children, ages 3 to 17 yr (group 1); 21 children, ages 5 to 19 yr with GH deficiency (group 2), and 30 subjects, ages 10 to 18 yr with idiopathic growth failure and normal GH stimulation tests (group 3). The output of urinary GH was measured in one acromegalic woman. The authenticity of urinary GH, 22 kDa, was confirmed by high-performance liquid chromatography. The elution pattern of urinary GH was identical to that of biosynthetic and pituitary-derived GH. The immunoreactive profiles characterized by monoclonal immunoradiometric GH assay and standard GH radioimmunoassay were identical. The quantity of GH (mean +/- SEM per kg body weight) in group 1 (0.27 +/- 0.02 ng/kg) was significantly greater than group 2 (0.08 +/- 0.02 ng/kg) or group 3 (0.17 +/- 0.02 ng/kg, p less than 0.01). Approximately 50% of the subjects in group 3 had urinary GH measurements indistinguishable from those observed in the GH-deficient population. Twelve hypopituitary patients (group 2) excreted significantly greater amounts of urinary GH in the first 12 h after GH administration compared to the baseline period (0.41 +/- 0.07 versus 0.12 +/- 0.02 ng/kg, p less than 0.01). Markedly elevated output of urinary GH (2.0 ng/kg) was documented in one acromegalic patient. The data suggest that measurements of urinary GH may be a useful, simple, and noninvasive screening test for identifying patients with GH deficiency or excess.