Growth hormone secretion provoked by insulin-induced hypoglycaemia in children of short stature.

Stimmler, L.; Brown, Gregory A.

doi:10.1136/adc.42.223.232

Cited by 27 publications

(17 citation statements)

References 14 publications

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“…GH values in individual children studied during therapy and after steroid withdrawal were found to be fairly reproducible and showed no differences in relation to corticosteroid administration. The plasma growth hormone concentrations reported here are similar to the values which have been observed in other children (17)(18)(19).…”

Section: Resultssupporting

confidence: 90%

“…Adults have low fasting levels of GH (< 5 mug/ml) and show a brisk response to hypoglycem a with postinsulin GH values of > 40 mtg/ml (23). In contrast the children in this study, as well as those reported by other investigators (17)(18)(19), have higher fasting levels of GH (6-8 mug/ml) and show a smaller magnitude of rise in GH level (15- mn4g/ml) (24). These studies indicate that plasma GH levels can be expected to vary with age and suggest that some of the mechanisms that control pituitary GH release may be different in children and in adults.…”

Section: Resultssupporting

confidence: 57%

“…Similar studies have shown that children with other nonpituitary forms of dwarfism also have normal levels of GH during fasting and after hypoglycemia (17)(18)(19). However it is recognized that pituitary release of GH in response to an artificial, severe hypoglycemic stimulus may not be comparable to GH release under more normal conditions.…”

Section: Resultsmentioning

confidence: 94%

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Plasma growth hormone concentration in corticosteroid-treated children

Morris¹,

Jørgensen²,

Jenkins³

1968

J. Clin. Invest.

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Section: Resultssupporting

confidence: 90%

Section: Resultssupporting

confidence: 57%

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Plasma growth hormone concentration in corticosteroid-treated children

Morris¹,

Jørgensen²,

Jenkins³

1968

J. Clin. Invest.

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“…Most children with growth retardation have normal plasma levels of GH and show normal responsiveness to induced hypoglycemia (24,60,61). Furthermore, such children show little or no improvement in growth rate during therapy with HGH (27,50).…”

Section: Discussionmentioning

confidence: 99%

Metabolic effects of human growth hormone in corticosteroid-treated children

Morris¹,

Jørgensen²,

Elrick³

et al. 1968

J. Clin. Invest.

101

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A B S T R A C T The effects of administered human growth hormone (HGH) were evaluated in dwarfed, prepubertal children who were receiving long-term corticosteroid therapy for a chronic disease. During 11 complete metabolic balance studies, the eight corticosteroid-treated children demonstrated impaired response to large doses of HGH with minimal nitrogen and no phosphorus retention. In contrast, two hypopituitary subjects and two asthmatic children not receiving corticosteroid responded to the same preparations of HGH with nitrogen, potassium, and phosphorus retention. Six corticosteroid-treated children were given large doses of HGH (40-120 mg/wk for 4 to 8 months and showed no improvement in their retarded rate of growth, whereas the hypopituitary subjects showed accelerated growth during administration of 10-15 mg of HGH/wk. It is concluded that dwarfism in steroid-treated children results from corticosteroid-induced antagonism of the effects of HGH at the peripheral tissue level.

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“…On the other hand, a missed diagnosis will deprive the patient of treatment, resulting in an unfavorable clinical outcome. The first stimulation tests to explore the GH reserve in children were performed during the late 1960s and early 1970s (3,4,5,6,7). There is a consensus that a unique cutoff value should be used for various stimulation tests used for laboratory testing of GHD in children so far (e.g.…”

Section: Introductionmentioning

confidence: 99%

Clinical evidence-based cutoff limits for GH stimulation tests in children with a backup of results with reference to mass spectrometry

Wagner¹,

Paetzold²,

Gausche³

et al. 2014

European Journal of Endocrinology

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Context: Cutoff limits of GH stimulation tests to diagnose GH deficiency (GHD) in children and adolescents are not sufficiently validated by clinical studies due to discrepancies in the performance of GH immunoassays and lack of available study populations. Objective: We aimed to establish new cutoff limits for GH stimulation tests based on clinical evidence and compared these immunoassay-based values with an antibody-independent mass spectrometric method. Design and setting: In a retrospective study, GH cutoff limits for eight different immunoassays and isotope dilution mass spectrometry (ID-MS) were calculated from hGH peak concentrations of short-statured children with and without GHD. Patients: We compared the serum GH peak concentrations at GH stimulation test of 52 short-statured children and adolescents, who have normal GH secretion at initial workup and normal growth in the follow-up, with the serum GH peak concentrations of 44 GHD patients in the same age range, in order to optimize the cutoff limit calculation. Results: Discriminant analysis of re-measured GH led to a new cutoff limit of 7.09 mg/l using the iSYS assay (IDS) and the limits for the other seven hGH assays varied between 4.32 and 7.77 mg/l. For ID-MS, cutoffs of 5.48 mg/l (22k GH) and 7.43 mg/l (total GH) were ascertained. Conclusion: The establishment of method-specific clinical evidence-based GH cutoff limits is of importance to ensure adequate clinical diagnosis and treatment of children and adolescents with GHD. ID-MS may become an important tool for providing both reliable and sustainable SI traceability of GH measurements in the future.

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Growth hormone secretion provoked by insulin-induced hypoglycaemia in children of short stature.

Cited by 27 publications

References 14 publications

Plasma growth hormone concentration in corticosteroid-treated children

Plasma growth hormone concentration in corticosteroid-treated children

Metabolic effects of human growth hormone in corticosteroid-treated children

Clinical evidence-based cutoff limits for GH stimulation tests in children with a backup of results with reference to mass spectrometry

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