Urinary growth hormone excretion in the assessment off children with disorders of growth

Skinner, Andrew C.; Clayton, Peter E.; Price, David A.; Addison, G. M.; Soo, A.

doi:10.1111/j.1365-2265.1993.tb01774.x

Cited by 19 publications

(13 citation statements)

References 23 publications

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“…Previous studies have shown a positive correlation between urinary GH excretion and serum GH; either the 24-hour or the nocturnal (12-hour) GH excretion levels can reflect intrinsic GH secretion [28]. The sensitivity and specificity of nocturnal 12-hour GH excretion rate are 80% and 90%, respectively [29]. …”

Section: Methodsmentioning

confidence: 99%

Postreceptor Crosstalk on PI3K/Akt between GH and Insulin in Non-Catch-Up Growth Rats Born Small for Gestational Age

Huang

Du²,

Kuluz³

et al. 2008

Horm Res Paediatr

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Background/Aims: Children born small for gestational age (SGA) are at increased risk for short stature and type 2 diabetes mellitus as a result of growth hormone (GH) resistance and insulin resistance. The mechanisms of multiple hormone resistance remain unclear. This study was designed to investigate the relationship between GH resistance and insulin resistance in non-catch-up growth (NCU-SGA) rats, and how their signaling pathways are related based on their crosstalk on the insulin receptor substrate-1 phosphatidylinositol 3′-kinase (IRS-1-PI3K) pathway. Methods: NCU-SGA rat model was developed by restricting prenatal food intake in pregnant dams. Activated levels of IRS-1 and Akt in liver protein extracts were compared between NCU-SGA and age- and sex-matched controls born appropriate for gestational age rats at baseline, after insulin stimulation, and after pretreatment with AG490 (GH-JAK2 pathway inhibitor) followed by insulin stimulation. Results: GH secretion was positively related to markedly increased insulin levels in NCU-SGA rats. There was no difference of IRS-1 phosphorylation in response to insulin between two groups, however, insulin-stimulated Akt phosphorylation was attenuated in NCU-SGA rats compared to appropriate for gestational age rats. Pretreatment with AG490 restored the Akt response to insulin demonstrated by significantly increased Akt phosphorylation. Conclusion: GH plays a role in inducing insulin resistance via signaling crosstalk with insulin at the level of PI3K/Akt in NCU-SGA rats.

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Section: Methodsmentioning

confidence: 99%

Postreceptor Crosstalk on PI3K/Akt between GH and Insulin in Non-Catch-Up Growth Rats Born Small for Gestational Age

Huang

Du²,

Kuluz³

et al. 2008

Horm Res Paediatr

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“…The growth hormone (GH) secretion, which is maxi mal during the night, could be another factor contributing to this intradaily rhythm. This is supported by the finding that serum markers of osteoblastic activity such as osteo calcin and carboxyterminal propeptide of type I procol lagen display a circadian variation in serum concentra tion dependent on the GH secretion [4], Timed overnight collection of urine for measuring uri nary GH (uGH) provides a non-invasivc integrated mea sure of GH secretion [5][6][7] and may be used as a more accurate predictor of normality than GH provocation tests [8]. uGH measurements also have a role in studying the physiology of growth, and it has recently been shown that the nightly uGH excretion can also vary in a pulsatile fashion [9], The aim of this study was to investigate whether there is any relationship between changes in LLL as evidenced by knemometry and GH secretion as assessed by over night uGH excretion.…”

mentioning

confidence: 72%

Short-Term Changes in Urinary Growth Hormone Excretion and Lower Leg Length in Healthy Children

Ahmed

Barnes²,

Wallace³

et al. 1997

Horm Res

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To investigate any association between changes in lower leg length (LLL) and urinary growth hormone (uGH) excretion, 4 prepubertal children supplied daily 12-hour overnight urine samples and had daily knemometry performed for 4 weeks. The mean daily and weekly LLL velocity (LLLV) of the group was 0.08 mm/day (95% CI 0.01-0.18) and 0.52 mm/week (range 0.38-0.78), respectively. The mean uGH excretion was 8.9 ng/l (CI 3.7-13.3), and the mean intrasubject coefficient of variation of uGH was 55% (range 32-93). The tallest subject who also had the highest LLLV excreted the least amount of uGH (mean 3.7 ng/l, CI 2.9-4.5). No temporal relationship was evident between daily uGH excretion and LLL changes. There was no evidence of any association between amount of uGH excreted and LLLV. There remains some doubt on the usefulness of uGH measurement as the sole predictor of normal GH production.

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“…Recently, Skinner et al [26] compared the outcome of commonly used provocative GH tests to U-GH excretion measurement in the diagnosis of GHD and concluded that U-GH excretion would be a more accurate predictor of normality than the GH provocation tests. However, the clinical diagnosis of GHD in the 10 children studied was confirmed on GH provocation tests and U-GH excretion was above the cut-ofT levels in 2 of these patients.…”

Section: Discussionmentioning

confidence: 99%

“…These studies include a small number of normal or short normal children and only few studies described a large group of normal healthy children with regard to sex, age and pubertal maturation [23][24][25]. More recently, the use of U-GH measurements was recom mended in the assessment of children with disorders of growth [26].…”

Section: Introductionmentioning

confidence: 99%

The Wide Variation in Urinary Excretion of Human Growth Hormone in Normal Growing and Growth Hormone-Deficient Children Limits Its Clinical Usefulness

Léger

Reverchon²,

Porquet³

et al. 1995

Horm Res

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We measured urinary growth hormone (U-GH) excretion to estimate the spontaneous growth hormone (GH) production in normal children according to age, sex, height, body mass index, serum insulin-like growth factor-1 (IGF-1), and pubertal status. To assess the clinical usefulness of this parameter, U-GH excretion measurements were obtained in children with GH deficiency (GHD). One hundred and forty-nine prepubertal and 105 pubertal (Tanner stage 2-5) normal children, aged 3-17 years, were studied. They had heights and weights within 2 SD of age-corresponding normal measures. Two consecutive 24-hour urine collections were performed for all of them. Blood sampling for IGF-1 measurement was performed for 54 consented normal subjects. Forty-one children aged 1.8-13.8 years with classical GHD with at least two subnormal GH responses to provocative test were also evaluated. Nocturnal serum GH profile was also performed in 26 of them. GHD children were investigated for U-GH excretion just before human GH therapy. U-GH was measured by a two-step immunoradiometric method that we have developed using two monoclonal antibodies. Despite a wide intra- and interindividual variation, no difference was found related to age or sex in prepubertal normal children. U-GH excretion values were significantly dependent on the pubertal stage with 3.4-fold increased values compared to prepubertal stage in both sexes. In normal children, the U-GH excretion was related to serum IGF-1 values, but no relation was found with the height or the body mass index expressed as standard deviation score. U-GH excretion values were significantly lower in GHD children compared to those with normal stature (p < 0.0001) with an overlap between the two groups. No relation was found between the physiological GH concentration by serum measurement and urinary excretion in children diagnosed as GHD by the pharmacological GH test. In conclusion, U-GH excretion determination offers an evaluation of the endogenous growth hormone secretion. Unfortunately, the wide variation of U-GH excretion makes this measurement unreliable for individual assessment of GH secretion. Therefore, it is not a real alternative to GH stimulation testing.

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Urinary growth hormone excretion in the assessment off children with disorders of growth

Cited by 19 publications

References 23 publications

Postreceptor Crosstalk on PI3K/Akt between GH and Insulin in Non-Catch-Up Growth Rats Born Small for Gestational Age

Postreceptor Crosstalk on PI3K/Akt between GH and Insulin in Non-Catch-Up Growth Rats Born Small for Gestational Age

Short-Term Changes in Urinary Growth Hormone Excretion and Lower Leg Length in Healthy Children

The Wide Variation in Urinary Excretion of Human Growth Hormone in Normal Growing and Growth Hormone-Deficient Children Limits Its Clinical Usefulness

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