Objective: To analyse the diagnostic role of serum IGF-I, IGF-binding protein-3 (IGFBP-3), IGF-I/IGFBP-3 molar ratio and urinary GH (uGH) excretion in adult GH deficiency (GHD). Design: Twenty-seven adults (age range: 18-71 years) with severe GHD, defined by a peak GH response to an insulin tolerance test below 3 mg/l in patients with at least one additional pituitary hypofunction. Reference values were established from a selected age-and body mass index-matched population (154 healthy adults grouped in four age groups). Methods: IGF-I and IGFBP-3 were measured by RIA (Nichols) and results expressed as standard deviation (S.D.) scores from our reference population and assay normative data (S.D. score Nichols). uGH was measured by IRMA. Results: Within the control group, IGF-I, IGFBP-3, IGF-I/IGFBP-3 ratio standardisation regarding our control population and IGF-I with respect to the assay normative data resulted in disappearance of agerelated differences. However, IGFBP-3 S.D. score Nichols resulted in mean values between þ1.4 and þ2.5 S.D. score. Greatest diagnostic efficiency was for IGF-I standardised with respect to our controls (97.2%), followed by S.D. score IGFBP-3 (92.9%). S.D. score IGF/IGFBP-3 ratio and uGH showed poor diagnostic efficiency. Any combination of at least two abnormal parameters raised specificity to 100%. IGF-I standardised with respect to assay reference (S.D. score Nichols) showed similar diagnostic value (95.0%) whereas IGFBP-3 showed low sensitivity (33.3%). Within the GHD patients, those with three or more additional deficiencies had lower S.D. score IGF-I than those with only two or one. Conclusion: We underline the importance of an appropriate reference population for correct interpretation of GH secretion markers. Considering our results, specificity obtained with two simultaneous abnormal parameters when referred to an adequate reference population may add valuable information to alternative GH stimulation tests to confirm adult GHD.
ABSTRACT. To assess the clinical usefulness of urinary growth hormone (UGH) measurements, a UGH determination technique, including dialysis, ultrafiltration, and measurement by polyclonal-coated tube RIA, was established. Sixty-three short children were studied: 56 idiopathic growth retarded (37 prepubertal and 19 pubertal) and seven prepubertal with classic GH (growth hormone) deficiency. Forty-two healthy children (32 prepubertal and 10 pubertal) served as controls.
The urinary excretion of free cortisol in a group of 10 control and 20 morbidly obese women was measured in all bladder voidings during 24 h. The data from obese women were measured under Hospital basal controlled conditions and after 3 days of very low calorie diet (VLCD, 1.9 MJ/d). The hourly cortisol excretion pattern was determined for each woman, and means of each group were computed in order to obtain a 24 h excretion pattern. In controls, the highest excretion rate was in the morning (8-9 h) and the lowest at 21-22 h. Inbasal conditions, the obese showed a similar but flatter pattern; the highest peak was also in the morning (9-10 h), but the lowest rate was between 21 and 24 h. The VLCD diet flattened the pattern even more, in away that no clear peak was observed from the early morning until the afternoon; however, the nadir coincided with that found in basal conditions. These patterns resulted in significant differences between VLCD, basal diet and control. The amount of free cortisol excreted was 93.0 +/- 6.9 nmol/ day in controls, 70.1 +/- 4.7 nmol/day in obese under basal conditions and 62.6 +/- 3.0 nmol/day when subjected to VLCD. The results presented are consistent with a lower overall cortisol secretion in the morbid obese women, which also show a narrower margin of variation in cortisol secretion than non-obese controls. The data also show the significant influence of dietary energy on the pattern of cortisol excretion in obese women.
Objective: To determine whether the daily pattern of urine excretion of N wastes is affected by obesity and very low-calorie diets (VLCD). Design: The plasma amino acid, urea and other energy parameters, as well as the urinary excretion of total nitrogen, urea and creatinine were studied in obese and normal-weight women. The obese women's data were obtained under hospital basal controlled conditions (8.1 MJaday) and after 3 days of VLCD diet (1.9 MJaday) controls were studied only once (5.8 MJaday). The hourly excretion patterns of total N, urea and creatinine were determined from the composition of each bladder voiding. Subjects: Twenty morbidly obese and 10 age-matched normal-weight control women. Results: Plasma amino acid levels were higher in obese women, which showed a limited ability to metabolize amino acid hydrocarbon skeletons. Neither differences in the patterns between groups nor total 24 h values for urine volume were found. Total N and urea excretion diminished under VLCD diet. Hourly creatinine excretion showed a¯at pattern and was higher in obese women than in the controls, VLCD diet diminished the amount of creatinine excreted in 24 h. Conclusions: The early change in energy availability that the creatinine excretion ®gures re¯ect may result from the energy conservation mechanisms induced in response to energy restriction. The early onset of this effect (3 days, and the extent of decrease ( $ 19%) also suggest that the impact of VLCD on the muscle energy budget of the obese is more marked than usually assumed. Sponsorship: Grants FIS-94a0034, BIO98-0316 and 2FD97-0233 of the Government of Spain.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.