Prevalence of refractoriness when testing growth hormone levels in children
(2023) In Growth Hormone and IGF Research 71.- Abstract
Objective: Late night spontaneous growth hormone (GH) pulses may influence the pituitary GH response to provocation tests. We evaluated GH response during arginine-insulin-tolerance test (AITT) after a GH peak during a short spontaneous nocturnal profile (SSNP) in children with short stature or low growth velocity. Design: Using SSNP and subsequent AITT, we examined 257 children 4–18 years old (138 (53.7%) males) recruited from three hospitals. Medical records were reviewed retrospectively. Refractory children were defined as a GH peak ≥7 μg/L during SSNP but no GH peak ≥7 μg/L during AITT. Results: In total, 201/257 children had a GH peak ≥7 μg/L at SSNP and/or AITT. Of these, 21.9% were refractory. The proportion of males (p = 0.033)... (More)
Objective: Late night spontaneous growth hormone (GH) pulses may influence the pituitary GH response to provocation tests. We evaluated GH response during arginine-insulin-tolerance test (AITT) after a GH peak during a short spontaneous nocturnal profile (SSNP) in children with short stature or low growth velocity. Design: Using SSNP and subsequent AITT, we examined 257 children 4–18 years old (138 (53.7%) males) recruited from three hospitals. Medical records were reviewed retrospectively. Refractory children were defined as a GH peak ≥7 μg/L during SSNP but no GH peak ≥7 μg/L during AITT. Results: In total, 201/257 children had a GH peak ≥7 μg/L at SSNP and/or AITT. Of these, 21.9% were refractory. The proportion of males (p = 0.033) and body mass index (BMI) standard deviation score (SDS) (p = 0.037) were higher in the refractory group than in children with a GH peak ≥7 μg/L during AITT. The median period between last GH peak ≥7 μg/L during SSNP and GHmax at AITT was 210 (30–390) minutes. The GHmax at AITT occurred 30 min earlier for children without a peak ≥7 μg/L during the SSNP (p = 0.004). The number of refractoriness differed somewhat between the hospitals (p = 0.025). Conclusions: Many children with short stature were refractory at testing; among them we found few clinical characteristics. Refractoriness might be influenced by some differences in procedure, but needs to be considered when evaluating GH response in children.
(Less)
- author
- Borghammar, Camilla LU ; Boije, Victoria ; Becker, Charlotte LU ; Lindberg, Bengt LU and Elfving, Maria LU
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Arginine-insulin-tolerance test (AITT), Child, Growth hormone (GH), Refractoriness, Spontaneous nocturnal profile
- in
- Growth Hormone and IGF Research
- volume
- 71
- article number
- 101549
- publisher
- Elsevier
- external identifiers
-
- scopus:85166985053
- pmid:37562165
- ISSN
- 1096-6374
- DOI
- 10.1016/j.ghir.2023.101549
- language
- English
- LU publication?
- yes
- id
- f3f5b6e6-280b-4317-9dbb-3a54b01f5b12
- date added to LUP
- 2023-10-31 13:27:40
- date last changed
- 2024-08-09 13:09:17
@article{f3f5b6e6-280b-4317-9dbb-3a54b01f5b12, abstract = {{<p>Objective: Late night spontaneous growth hormone (GH) pulses may influence the pituitary GH response to provocation tests. We evaluated GH response during arginine-insulin-tolerance test (AITT) after a GH peak during a short spontaneous nocturnal profile (SSNP) in children with short stature or low growth velocity. Design: Using SSNP and subsequent AITT, we examined 257 children 4–18 years old (138 (53.7%) males) recruited from three hospitals. Medical records were reviewed retrospectively. Refractory children were defined as a GH peak ≥7 μg/L during SSNP but no GH peak ≥7 μg/L during AITT. Results: In total, 201/257 children had a GH peak ≥7 μg/L at SSNP and/or AITT. Of these, 21.9% were refractory. The proportion of males (p = 0.033) and body mass index (BMI) standard deviation score (SDS) (p = 0.037) were higher in the refractory group than in children with a GH peak ≥7 μg/L during AITT. The median period between last GH peak ≥7 μg/L during SSNP and GH<sub>max</sub> at AITT was 210 (30–390) minutes. The GH<sub>max</sub> at AITT occurred 30 min earlier for children without a peak ≥7 μg/L during the SSNP (p = 0.004). The number of refractoriness differed somewhat between the hospitals (p = 0.025). Conclusions: Many children with short stature were refractory at testing; among them we found few clinical characteristics. Refractoriness might be influenced by some differences in procedure, but needs to be considered when evaluating GH response in children.</p>}}, author = {{Borghammar, Camilla and Boije, Victoria and Becker, Charlotte and Lindberg, Bengt and Elfving, Maria}}, issn = {{1096-6374}}, keywords = {{Arginine-insulin-tolerance test (AITT); Child; Growth hormone (GH); Refractoriness; Spontaneous nocturnal profile}}, language = {{eng}}, publisher = {{Elsevier}}, series = {{Growth Hormone and IGF Research}}, title = {{Prevalence of refractoriness when testing growth hormone levels in children}}, url = {{http://dx.doi.org/10.1016/j.ghir.2023.101549}}, doi = {{10.1016/j.ghir.2023.101549}}, volume = {{71}}, year = {{2023}}, }