Growth Hormone Stimulation Testing: To Test or Not to Test? That Is One of the Questions

Yau, Mabel; Rapaport, Robert

doi:10.3389/fendo.2022.902364

Cited by 9 publications

(4 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Also, the deficiency cut-off of 10 ng/mL is not reflective of severe GHD. Growth hormone stimulation testing is known to have poor specificity and reproducibility, and a substantial percentage of healthy children, as well as children with obesity and pre-pubertal status, may falsely test below the accepted cut-off [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Effects of Growth Hormone on the Cellular Immunologic Landscape in Pediatric Patients

Gujral,

Kidd,

Becker

et al. 2024

Cureus

Self Cite

View full text Add to dashboard Cite

Introduction: Growth hormone (GH) and the immune system have multiple bidirectional interactions. Data about the acute effects of GH on the immune system are lacking. The objective of our study was to evaluate the acute effects of GH on the immune system using time-of-flight mass cytometry. Methods: This was a prospective study of pediatric patients who were being evaluated for short stature and underwent a GH stimulation test at a tertiary care center. Blood samples for immunologic markers, i.e., complete blood count (CBC) and time of flight mass cytometry (CyTOF), were collected at baseline (T0) and over the course of three hours (T3) of the test. Differences in immune profiling in patients by timepoint (T0, T3) and GH response (growth hormone sufficient (GHS) versus growth hormone deficient (GHD)) were calculated using a two-way ANOVA test. Results: A total of 54 patients (39 boys and 15 girls) aged five to 18 years were recruited. Twenty-two participants tested GHD (peak GH <10 ng/ml). The CyTOF analysis showed a significant increase from T0 to T3 in granulocyte percentage, monocyte count, and dendritic cell (DC) count; in contrast, a significant decrease was seen in T lymphocytes (helper and cytotoxic) and IgD+ B lymphocytes. The CBC analysis supported these findings: an increase in total white blood cell count, absolute neutrophil count, and neutrophil percentage; a decrease in absolute lymphocyte count, lymphocyte percentage, absolute eosinophil count, and absolute monocyte count. No significant differences were found between CBC/CyTOF measurements and GH status at either time. Conclusions: This study provides the first high-resolution map of acute changes in the immune system with GH stimulation. This implies a key role for GH in immunomodulatory function.

show abstract

Section: Discussionmentioning

confidence: 99%

Acute Effects of Growth Hormone on the Cellular Immunologic Landscape in Pediatric Patients

Gujral,

Kidd,

Becker

et al. 2024

Cureus

Self Cite

View full text Add to dashboard Cite

show abstract

“…Many clinicians classify GHD as a continuum from severe to normal, and with the development of more sensitive testing, some clinicians may use 5 or 7 μg/dL as the cutoff for GHD, although the currently accepted cutoff is still 10 μg/dL [ 2 ]. GHST still remains an essential part of GHD diagnosis in the context of the rest of the clinical picture [ 1 , 3 ].…”

Section: Discussionmentioning

confidence: 99%

Late-Onset Isolated Growth Hormone Deficiency

et al. 2023

Self Cite

View full text Add to dashboard Cite

Two male patients, who presented at 13.5 and 13.9 years of age with growth failure and short stature, were ultimately diagnosed with isolated growth hormone deficiency (GHD). Patient 1 was first evaluated when his height declined from −0.67 SD to −1.3 SD. He had a peak growth hormone (GH) concentration to GH stimulation test (GHST) of 16.9 ng/mL (16.9 μg/L) and remained untreated. As puberty advanced, his height decreased further to −1.65 SD. A second GHST while his serum testosterone was 79 ng/dL (2.74 nmol/L) had a peak GH of 5.4 ng/mL (5.4 μg/L), consistent with GHD. He was treated with GH for 4.8 years and reached adult height of 180.5 cm (0.57 SD), gaining 2.22 SDS. Patient 2, height −2.63 SD, had an unstimulated peak GH concentration of 19 ng/mL (19 μg/L). As puberty advanced, his height decreased further to −2.96 SD. Repeat peak GH concentration was 9.2 ng/mL (9.2 μg/L) when serum testosterone was 83.9 ng/dL (2.91 nmol/L). GH treatment resulted in rapid increase of height velocity from 1.8 cm/year to 11.3 cm/year in 6 months, consistent with GHD. Both patients demonstrate that GHD may develop over time and cannot be excluded by a single GHST. Longitudinal monitoring of children with poor growth as puberty progresses is essential to uncover GHD.

show abstract

“…These inaccuracies occur because the stimuli are not physiological and do not replicate normal secretory dynamics. Also, the periodic secretion of somatostatin might influence the somatotroph response [ 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of Recombinant Human Growth Hormone Treatment in a Patient with Short Stature Associated with the Ring Chromosome 17 Syndrome

Tempone Cardoso Penna,

de Rezende Lelot,

de Rezende Lelot

et al. 2023

Case Reports in Pediatrics

View full text Add to dashboard Cite

Background. Ring chromosome 17 syndrome is a rare hereditary disorder whose prevalence is less than 1 : 1.000.000. We present a ten-year-old patient with ring chromosome 17 syndrome who had short stature and was treated with recombinant human growth hormone (rhGH). Case Report. A ten-year-old male scholar had moderate left conductive deafness, left kidney hypoplasia with hypertension, epilepsy, malformations in hands, feet, and abdomen, and disproportionately short stature. Despite no evidence of growth hormone deficiency, rhGH treatment was indicated as a therapeutic test due to his decelerated growth velocity and severe short stature. As a result, his growth velocity increased by 4.2 cm per year and his stature Z-score increased (from −5.87 to −5.23). Conclusion. The patient’s severe short stature may be related to genetic, environmental, and hormonal factors and the positive response to rhGH may indicate abnormalities in the somatotropic axis that were mitigated with the treatment. Although rhGH associated with adequate comorbidities controls improved his growth velocity and height Z-score, its effects in the long term are still unclear.

show abstract

Growth Hormone Stimulation Testing: To Test or Not to Test? That Is One of the Questions

Cited by 9 publications

References 53 publications

Acute Effects of Growth Hormone on the Cellular Immunologic Landscape in Pediatric Patients

Acute Effects of Growth Hormone on the Cellular Immunologic Landscape in Pediatric Patients

Late-Onset Isolated Growth Hormone Deficiency

Effect of Recombinant Human Growth Hormone Treatment in a Patient with Short Stature Associated with the Ring Chromosome 17 Syndrome

Contact Info

Product

Resources

About