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Do short children secrete insufficient growth hormone?

Z Zadik, S A Chalew, S Raiti

    Pediatrics
    |September 1, 1985
    PubMed

    Insights

    Measuring integrated growth hormone concentration in children helps identify those with impaired secretion, even with normal stimulation test results. This method may better predict response to growth hormone therapy for short stature.

    Area of Science:

    • Pediatric Endocrinology
    • Growth Hormone Physiology

    Background:

    • Short stature in children is a common clinical concern.
    • Standard pharmacologic stimulation tests are used to assess growth hormone (GH) secretion.
    • However, some children with short stature and normal GH responses to stimulation exhibit poor growth, suggesting limitations in current diagnostic methods.

    Purpose of the Study:

    • To compare 24-hour integrated GH concentration in children with normal stature versus short children.
    • To evaluate the utility of integrated GH concentration in identifying children with impaired spontaneous GH secretion despite normal stimulation test results.
    • To determine if integrated GH concentration can better predict response to GH therapy in short children.

    Main Methods:

    • Collected 24-hour integrated GH concentrations from 46 children of normal stature and 90 short children.
    • Classified short children into groups based on standard pharmacologic GH stimulation tests (deficient vs. normal response).
    • Statistically compared mean integrated GH concentrations across groups: normal stature, short with normal stimulation, and short with GH deficiency.

    Main Results:

    • Mean integrated GH concentration was significantly higher in normal stature children (6.6 ng/mL) compared to short children with normal stimulation (3.8 ng/mL) and those with GH deficiency (1.6 ng/mL).
    • A significant proportion (45%) of short children with normal stimulation tests had integrated GH concentrations overlapping with the GH-deficient group, suggesting impaired spontaneous secretion.
    • This overlap indicates a spectrum of spontaneous GH secretion even in children with normal stimulation responses.

    Conclusions:

    • Integrated GH concentration provides a more nuanced assessment of spontaneous GH secretion than stimulation tests alone.
    • Short children with normal GH stimulation but low integrated GH levels may represent a distinct subgroup with potential for growth hormone therapy.
    • Integrated GH concentration may be a superior biomarker for identifying short children who could benefit from growth hormone therapy.

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