ECEESPE2025 ePoster Presentations Pituitary, Neuroendocrinology and Puberty (220 abstracts)
GH secretion inhibition test in children - should we use different standards for obese children vs. normal weight children?
Paula Smalczewska 1 , Renata Stawerska 1,2 , Marzena Kolasa-Kicińska 1 , Krzysztof Jeziorny 1,2 , Anna Łupińska 1,2 , Joanna Krasińska 1 , Angelika Pakuła 1 , Sylwia Rajewska 1 , Maciej Hilczer 1 & Arkadiusz Zygmunt 1,3
1Polish Mother’s Memorial Hospital - Research Institute of Lodz, Department of Endocrinology and Metabolic Diseases, Lodz, Poland; 2Medical University of Lodz, Department of Paediatric Endocrinology, Lodz, Poland; 3Medical University of Lodz, Department of Endocrinology and Metabolic Diseases, Lodz, Poland.
JOINT3598
Hyperglycemia causes strong inhibition of growth hormone (GH) secretion. This phenomenon is used in the diagnosis of suspected GH excess during the GH suppression test after oral glucose administration (OGTT). In our previous work, we determined that the discriminant value for normal GH suppression during this test is < 1.1 ng/ml, and this nadir occurred at each of the assessed time points. Recently, there has been discussion about the influence of obesity on the interpretation of GH secretion in stimulation tests and the need to use different (lower) norms for people with obesity. The aim of this work was to present the results of GH concentration during the suppression test performed in children with obesity (in whom OGTT was performed for other reasons, and gigantism was excluded.
Material and Methods: A group of 171 children aged 4 to 17.2 years with various endocrine disorders was divided into 2 subgroups based on the SDS BMI index. The group of children with normal body weight (SDS BMI in the range of -2.0 to 2.0) included 57 people (40 girls and 17 boys). The group of children with excessive body weight (SDS BMI > 2.0) included 114 patients (66 girls and 48 boys). In each child, OGTT was performed after the administration of glucose at a dose of 1.75 g/kg (max. 75 g) with the assessment of glucose and GH concentration at time points 0, 30, 60, 90 and 120 minutes. In children, gigantism was excluded - based on the normal IGF-1 concentration or higher IGF-1 with exclusion of the presence of pituitary adenoma in MRI examination with contrast.
Results: In the subgroup of children with normal body weight, the minimum GH concentration during the test (from 0 to 120 minutes) ranged from 0.07 to 1.05 ng/ml, and the maximum - from 0.05 to 13.74 ng/ml. In the subgroup of children with obesity, the minimum GH concentration during the test ranged from 0.02 to 1.07 ng/ml, and the maximum from 0.11 to 17.29 ng/ml. In both groups, there were no statistically significant differences between the lowest GH concentrations (nadir).
Conclusion: If it is necessary to perform a suppression test in a child with obesity, it seems that the same cut-off point should be used to exclude gigantism; i.e. GH level < 1.1 ng/ml occurring in at least one of the 5 time points of the suppression test after oral glucose administration.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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