Effect of Body Mass Index on Peak Growth Hormone Response to Provocative Testing in Children with Short Stature

Stanley, Takara L.; Levitsky, Lynne L.; Grinspoon, Steven; Misra, Madhusmita

doi:10.1210/jc.2009-1369

Cited by 96 publications

(90 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, a negative correlation was found between GH peak response to the combined test and BMI and BMI SDS, suggesting that BMI influences GH response to provocative tests, as reported in non-PWS subjects [34,35,36,37]. In our PWS cohort only 2 patients were obese.…”

Section: Discussionsupporting

confidence: 62%

Growth Hormone Response to Standard Provocative Stimuli and Combined Tests in Very Young Children with Prader-Willi Syndrome

et al. 2014

View full text Add to dashboard Cite

Background: In Prader-Willi syndrome (PWS) a reduced growth hormone (GH) response to several stimulators has been documented in many studies, but none have focused on very young children. We evaluated the pattern of GH secretion in very young PWS patients. Patients and Methods: Twenty-seven genetically confirmed PWS children (10 females, aged 0.4-5 years, mean: 2.2 ± 1.4 years) were included. All subjects underwent standard provocative tests (clonidine, CLO; and arginine, ARG) and one combined test [growth hormone-releasing hormone (GHRH) plus pyridostigmine (13 patients) or GHRH plus arginine (14 patients)]. Insulin-like growth factor-1 (IGF-1) levels were also measured. Results: While standard tests (CLO and ARG) showed low GH peak in 85.2 and 70.4% of the patients, respectively, the combined test was found to be normal in 85.2%. IGF-1 was low in 66.7% of patients. Out of 27 patients, 3 (11%) showed a normal GH peak with both standard tests (group A), 6 (22%) to one of the standard tests (group B) and 18 (67%) presented a low response to both standard tests (group C). Four subjects showed low response to both the combined and standard tests and reduced IGF-1. Conclusion: Our data suggest that very young PWS children seem to have impaired hypothalamic GHRH secretion with a normal GH pituitary reserve.

show abstract

Section: Discussionsupporting

confidence: 62%

Growth Hormone Response to Standard Provocative Stimuli and Combined Tests in Very Young Children with Prader-Willi Syndrome

et al. 2014

View full text Add to dashboard Cite

show abstract

“…In another study by Albertsson-Wikland et al [20], the GH secretion rate correlated negatively with weight for height expressed in SDS in pubertal children. Stanley et al [21] demonstrated that higher BMI was associated with lower GH secretion in 116 children with short stature and suggested that the relationship between BMI and peak GH was not unique to obesity but rather persists in the normal-weight pediatric population. The pathogenesis of GH insufficiency in obesity is unclear.…”

Section: Discussionmentioning

confidence: 99%

Influence of Body Mass Index on Growth Hormone Responses to Classic Provocative Tests in Children with Short Stature

Lee

Hwang²

2011

Neuroendocrinology

View full text Add to dashboard Cite

Background: The diagnosis of growth hormone (GH) deficiency is based on a reduced peak GH response to provocative tests. However, the provocative tests are poorly reproducible and GH secretion is regulated by physiological parameters, such as body weight and puberty. The aim of this study was to assess the influence of body mass index (BMI) on GH response to provocative testing and to analyze the reproducibility of GH stimulation test. Methods: Clinical data were collected retrospectively by chart review from the Pediatric Endocrine Unit at the Ajou University Hospital. A total of 187 subjects with short stature who completed a GH stimulation testing between 2003 and 2009 were included in the study. Results: Of the 187 subjects, 66 (35.3%) had GH deficiency, while 121 (64.7%) were categorized as having idiopathic short stature. Reliability was calculated for 48 patients with idiopathic short stature who underwent the GH stimulation test twice. A GH response ≧10 ng/ml after retesting was found in 39 patients (81.3%) and a GH response <10 ng/ml was found in 9 patients (18.7%). In a stepwise multivariate analysis, BMI was a significantly independent predictor of peak GH. Elevated BMI was negatively associated with peak plasma GH levels. Conclusions: The lack of reliability of GH values in response to pharmacological stimuli should be taken into account in the diagnosis of GH deficiency. Also, higher BMI is associated with lower GH secretion. BMI should be measured and GH results appropriately interpreted for all subjects undergoing GH stimulation testing.

show abstract

“…Przy tym za ciężki niedobór GH (sGHD) u dziecka przyjmuje się zazwyczaj maksymalny wyrzut GH poniżej 5 ng/ml, a za częściowy niedobór GH (pGHD) maksymalny wyrzut GH pomiędzy 5 a 10 ng/ml [14][15][16]. Liczne doniesienia wskazują jednak na brak powtarzalności testów, co znacznie ogranicza ich wartość diagnostyczną [7,12,[17][18][19].…”

Section: Wstępunclassified

“…Wykonuje się określone badania laboratoryjne [5][6][7][8]26]. Różnorodność testów stymulujących wyrzut GH wskazuje na trudności z uzyskaniem powtarzalnych wyników, a także na niedoskonałość metod diagnostycznych [7,12,[17][18][19].…”

Section: Dyskusjaunclassified

See 1 more Smart Citation

The Prognostic Value of The Growth Hormone Secretion Stimulating Tests withl-dopa and clonidine in Children with Growth Hormone Deficiency Treated with Recombinant Human Growth Hormone in Western Pomeranian Region

Biczysko-Mokosa¹,

Petriczko²,

Horodnicka‐Józwa³

et al. 2016

Pediatr. Endocrinol.

View full text Add to dashboard Cite

Effect of Body Mass Index on Peak Growth Hormone Response to Provocative Testing in Children with Short Stature

Abstract: In children with short stature, BMI affects peak stimulated GH and should be considered when interpreting GH testing. Higher BMI SDS, even within the normal range, may lead to overdiagnosis of GH deficiency.

Cited by 96 publications

References 27 publications

Growth Hormone Response to Standard Provocative Stimuli and Combined Tests in Very Young Children with Prader-Willi Syndrome

Growth Hormone Response to Standard Provocative Stimuli and Combined Tests in Very Young Children with Prader-Willi Syndrome

Influence of Body Mass Index on Growth Hormone Responses to Classic Provocative Tests in Children with Short Stature

The Prognostic Value of The Growth Hormone Secretion Stimulating Tests withl-dopa and clonidine in Children with Growth Hormone Deficiency Treated with Recombinant Human Growth Hormone in Western Pomeranian Region

Contact Info

Product

Resources

About