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Nocturnal urinary growth hormone excretion in children with short stature
N Hattori1, A Shimatsu, C Yamanaka
1Department of Medicine, Kyoto University Faculty of Medicine, Japan.
Insights
Measuring nocturnal urinary growth hormone (GH) levels in children is a simple screening method. This test helps differentiate causes of short stature by assessing GH excretion during sleep.
Area of Science:
- Pediatric Endocrinology
- Biochemical Analysis
- Growth Hormone Physiology
Background:
- Short stature in children can stem from various causes, including growth hormone (GH) deficiency.
- Accurate assessment of GH levels is crucial for diagnosis and treatment planning.
- Current methods for assessing GH secretion can be invasive or complex.
Purpose of the Study:
- To evaluate the utility of measuring nocturnal urinary GH excretion as a simple screening tool for children with short stature.
- To correlate urinary GH excretion with plasma GH levels obtained from pharmacological and sleep tests.
- To differentiate between various etiologies of short stature based on urinary GH excretion patterns.
Main Methods:
- Nocturnal urinary samples were collected from children with short and normal stature.
- A sensitive enzyme immunoassay was used to quantify urinary GH levels.
- Urinary GH excretion was correlated with peak plasma GH values from pharmacological and sleep stimulation tests.
Main Results:
- Urinary GH excretion during sleep showed a positive correlation with peak plasma GH values from both pharmacological (r=0.74) and sleep (r=0.85) tests.
- Significant differences in urinary GH excretion were observed between groups with complete GH deficiency, partial GH deficiency, and short stature without GH deficiency.
- No significant difference in urinary GH excretion was found between children with short stature without GH deficiency and those with normal stature.
Conclusions:
- Nocturnal urinary GH excretion measurement is a simple and effective method for screening GH excretion in children.
- This method aids in differentiating the causes of short stature, particularly distinguishing GH deficiency from other etiologies.
- Urinary GH measurement offers a valuable, non-invasive approach for pediatric endocrine assessment.
Abstract:
Nocturnal urinary growth hormone levels in children with short and normal stature were measured by a sensitive enzyme immunoassay. Urinary GH excretion during sleep correlated positively with peak plasma GH values during pharmacological (r = 0.74, P less than 0.001) and sleep (r = 0.85, P less than 0.001) tests. The amounts of urinary GH excretion during sleep differed significantly from each other in the following groups: complete GH deficiency (mean +/- SEM: 0.1 +/- 0.1 ng/m2 of body surface area; range: less than 0.1-0.4), partial GH deficiency (1.6 +/- 0.3 ng/m2; 0.2-3.1), and short stature without GH deficiency (3.7 +/- 0.6 ng/m2; 0.7-11.5). No significant difference was found between short stature without GH deficiency and normal stature (5.0 +/- 0.5 ng/m2; 2.1-10.5). Measurement of nocturnal urinary GH excretion is a simple method for screening of GH excretion and may be helpful in the differentiation of the various etiologies of short stature in children.