ECE2021 Presented Eposters Presented ePosters 3: Pituitary and Neuroendocrinology (8 abstracts)
Comparative study of growth hormone stimulation levels in growth hormone deficient children vs children with idiopathic short stature
Sofia Leka-Emiri 1 , Fani Athanasouli 1 , Dimitra Tampouratzi 1 , Maria Kafetzi 2 , Eirini Dikaiakou 1 , Vasilios Petrou 1 , Elpis Vlachopapadopoulou 1 & Stefanos Michalakos 1
1Endocrinology-Growth and Development, “P&A KYRIAKOU” Children’s Hospital, Athens, Greece; 2Biochemistry-Hormonology, “P&A KYRIAKOU” Children’s Hospital, Athens, Greece
Introduction
Short stature (SS) assessment includes the documentation of growth hormone (GH) secretion via GH stimulation tests.
Objectives
To study retrospectively GH stimulation test results among Greek children with SS and investigate differences among GH deficient (GHD) children vs idiopathic short stature (ISS).
Methods
Data were collected retrospectively from 190 children who visited the pediatric endocrine clinic for the evaluation of SS. Age, gender, weight z-score, height z-score, BMI z-score, Tanner stages, bone age, annual growth rate, target height, insulin-like growth factor 1 (IGF-1) levels and GH stimulation test results were collected from the electronic medical records. GHD is defined as a serum peak GH concentration <10 ng/ml in a combination of two separate tests with glucagon (peak GH-G) and clonidine (peak GH-C). Both IGF-1 and GH were measured by a chemiluminescence sandwich type immunoassay on the analyzer Liaison XL, Diasorin.
Results
Eighty-four children (44%) were diagnosed with GHD, 56 (29%) with ISS, 38 with chronic disease (20%) and 12 with SGA (small for gestational age) (6%). All data concerning GHD and ISS children are summarized in table 1. IGF-1 levels did not differ significantly among ISS and GHD children. Pubertal children in both groups had significantly higher (P: <0.001) IGF-1 levels as compared to prepubertal: 283 ng/ml vs 156 ng/ml in ISS group and 258 ng/ml vs 138 ng/ml in GHD group. IGF-1 levels were not sex dimorphic in any group. Peak GH-G and peak GH-C were significantly higher in ISS versus GHD children but did not differ significantly in respect to sex/puberty.
| All (190) | ISS (56) | GHD (84) | P value | |
| Chronological age (yr) | 9.5(3) | 10.2(2.6) | 9.3(3.2) | 0.34 |
| Sex (M/F) | 103/87 | 30/26 | 46/38 | |
| Gestational age (wk) | 37.9(2.0) | 38.5(1.5) | 37.7(2.5) | 0.11 |
| Birth length (cm) | 48.6(4.9) | 49.6(2.2) | 48.7(3.4) | 0.73 |
| Height SDS | -1.99(0.7) | -1.92(0.9) | -1.95(0.7) | 0.99 |
| BA-CA (yr) | -1.84(1.2) | -2.1(1.1) | -1.75(1.3) | 0.69 |
| BMI SDS | 0.1(1.8) | -0.06(0.9) | 0.35(1.1) | 0.61 |
| Tanner stage | ||||
| 1 | 137 | 36 | 64 | |
| >2 | 53 | 20 | 20 | |
| MPH SDS | -0.67(0.8) | -0.54(0.7) | -0.72(0.8) | 0.55 |
| IGF-1 (ng/ml) | 176.6(94.8) | 201.8(104.2) | 166.1(88.3) | 0.16 |
| Peak GH-G (ng/ml) | 8.6(6.7) | 12.2 (6.8) | 5.8(3.4) | <0.001 |
| Peak GH-C (ng/ml) | 8.1(5.1) | 11.7(5.4) | 5.7(2.7) | <0.001 |
Conclusion
GH stimulation test is of greater interest than IGF-1 levels alone in differentiating GHD from ISS children irrespective of puberty or sex.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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