BACKGROUND: The growth hormone (GH) Research Society proposed criteria based on auxological parameters (height, difference between target and actual heights, growth rate) to predict GH deficiency (GHD) followed by GH stimulation tests. These criteria are very sensitive but not specific enough. The objective of this study was to improve screening for GHD, so reducing the need for stimulation tests. MATERIAL/ METHODS: The patients were divided into three groups: Group 1 (n=54) with GHD and pituitary stalk interruption syndrome; Group 2 (n=104) with a normal GH peak after pharmacological and sleep tests; Group 3 (n=19) with transient GHD. The GHD diagnosis was based on the parameters proposed by the GH Research Society to evaluate the GH secretion, first alone and then plus plasma insulin-like growth factor (IGF) I concentrations. Data were analysed using the logical analysis of data framework. RESULTS: Screening can be achieved using a simple graph based on IGF I and the growth rate (GR): (1) all patients below a given line (GR < or =-7.3 - 1.3xIGF (SDS)) had GHD; (2) all but two patients above another given line (GR >-4.5 + 6.4/(IGF + 4.5) (SDS)) did not have GHD; (3) in-between, patients in a "gray area" cannot be diagnosed using only growth rate and IGF I. Most of the transient GHD were in or near the "gray area". CONCLUSIONS: Short children can be screened for GHD using growth rate and IGF I. Magnetic resonance imaging can then be used to detect pituitary stalk interruption syndrome or a tumor.
BACKGROUND: The growth hormone (GH) Research Society proposed criteria based on auxological parameters (height, difference between target and actual heights, growth rate) to predict GH deficiency (GHD) followed by GH stimulation tests. These criteria are very sensitive but not specific enough. The objective of this study was to improve screening for GHD, so reducing the need for stimulation tests. MATERIAL/ METHODS: The patients were divided into three groups: Group 1 (n=54) with GHD and pituitary stalk interruption syndrome; Group 2 (n=104) with a normal GH peak after pharmacological and sleep tests; Group 3 (n=19) with transient GHD. The GHD diagnosis was based on the parameters proposed by the GH Research Society to evaluate the GH secretion, first alone and then plus plasma insulin-like growth factor (IGF) I concentrations. Data were analysed using the logical analysis of data framework. RESULTS: Screening can be achieved using a simple graph based on IGF I and the growth rate (GR): (1) all patients below a given line (GR < or =-7.3 - 1.3xIGF (SDS)) had GHD; (2) all but two patients above another given line (GR >-4.5 + 6.4/(IGF + 4.5) (SDS)) did not have GHD; (3) in-between, patients in a "gray area" cannot be diagnosed using only growth rate and IGF I. Most of the transient GHD were in or near the "gray area". CONCLUSIONS: Short children can be screened for GHD using growth rate and IGF I. Magnetic resonance imaging can then be used to detect pituitary stalk interruption syndrome or a tumor.
Authors: Joanna Bladowska; Anna Biel; Anna Zimny; Katarzyna Lubkowska; Grazyna Bednarek-Tupikowska; Tomasz Sozanski; Urszula Zaleska-Dorobisz; Marek Sasiadek Journal: Med Sci Monit Date: 2011-10
Authors: João Soares Felício; Luísa Corrêa Janaú; Marcelle Alves Moraes; Nathalie Abdallah Zahalan; Fabrício de Souza Resende; Manuela Nascimento de Lemos; Norberto Jorge Kzan de Souza Neto; Isabela Imbelloni Farias de Franco; Loyane Tamyres Costa Leitão; Lilian de Souza d'Albuquerque Silva; Maria Clara Neres Iunes de Oliveira; Angélica Leite de Alcântara; Ana Carolina Contente Braga de Souza; Wanderson Maia da Silva; Márcia Costa Dos Santos; Natércia Neves Marques de Queiroz; Lorena Vilhena de Moraes; Antônio Bentes de Figueiredo; Ana Luiza Prieto Farinassi; Luciana Marques da Costa Farias; Danielle Dias da Silva; Karem Miléo Felício; João Felício Abrahão Neto Journal: Front Endocrinol (Lausanne) Date: 2019-09-19 Impact factor: 5.555