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Prevalence of refractoriness when testing growth hormone levels in children

Borghammar, Camilla LU orcid ; Boije, Victoria ; Becker, Charlotte LU ; Lindberg, Bengt LU and Elfving, Maria LU (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.

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author
; ; ; and
organization
publishing date
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
  • pmid:37562165
  • scopus:85166985053
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
2024-04-19 03:08:41
@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}},
}