| Abstrakt: |
Summary objective Several reports have suggested that IGF-I levels in patients with childhood-onset (CO) GH deficiency are lower than those observed in patients with adult-onset (AO) GH deficiency. However, these reports are unsatisfactory as there are several differences between the cohorts studied other than the timing of onset of GH deficiency; in particular, the patients were not matched for equal severity of GH deficiency. We have pursued this question further by examining the IGF-I standard deviation score (SDS) in patients with CO and AO GH deficiency, with equal degrees of severity of GH deficiency, as defined by the peak GH response to the insulin tolerance test (ITT). patients and measurements IGF-I SDS were compared in 146 non acromegalic patients (69 male), aged 15·7–76·6 years (median 33·4 years), bone mass index (BMI) 27·8 ± 5·8 kg/m2 , with severe GH deficiency (peak GH response < 9 mU/l to insulin-induced hypoglycaemia). Patients were subdivided by timing of onset of GH deficiency and the peak GH response to the ITT (GH response ≤ 1 mU/l, group 1; > 1–3 mU/l, group 2; > 3–6 mU/l, group 3; > 6–8·9 mU/l, group 4). results The IGF-I SDS (mean value ± SD) in the CO group (n = 63) as a whole was significantly lower than that found in the AO group ( n = 83) (-3·7 ± 2·8 vs. -1·55 ± 2·2, respectively; P < 0·0001). Despite this, there was no significant difference in the peak GH response to an ITT between the two cohorts (2·8 ± 2·3 mU/l in the AO cohort and 2·6 ± 2·2 mU/l in the CO cohort; P = 0·5). When the cohorts were subdivided by severity of GH deficiency, there remained a significant difference in IGF-I SDS in groups 1 ( P < 0·0001), 2 ( P = 0·05) and 3 ( P < 0·05), but there was no significant difference between the AO and CO cohorts in group 4. The peak GH response to an ITT was... [ABSTRACT FROM AUTHOR] |
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