Accuracy and limitations of the growth hormone (GH) releasing hormone-arginine retesting in young adults with childhood-onset GH deficiency
| Autor: | Flavia Napoli, Anna Allegri, Serena Noli, Annalisa Gallizia, Elena Tornari, Mariacarolina Salerno, Donatella Capalbo, Sandro Loche, Natascia Di Iorgi, Giuseppa Patti, Stefano Parodi, Anastasia Ibba, Maria Luisa Garrè, Grazia Maria Ubertini, Marco Crocco, Sara Notarnicola, Mohamad Maghnie, Marco Cappa |
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| Přispěvatelé: | Patti, Giuseppa, Noli, Serena, Capalbo, Donatella, Allegri, Anna Maria Elsa, Napoli, Flavia, Cappa, Marco, Ubertini, Grazia Maria, Gallizia, Annalisa, Notarnicola, Sara, Ibba, Anastasia, Crocco, Marco, Parodi, Stefano, Salerno, Mariacarolina, Loche, Sandro, Garré, Maria Luisa, Tornari, Elena, Maghnie, Mohamad, Di Iorgi, Natascia |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Arginine Endocrinology Diabetes and Metabolism Brain tumors GH deficiency GHRH-arg Transition Young adults 030209 endocrinology & metabolism lcsh:Diseases of the endocrine glands. Clinical endocrinology 03 medical and health sciences Endocrinology 0302 clinical medicine Internal medicine medicine Young adult Original Research lcsh:RC648-665 business.industry Insulin tolerance test Growth hormone secretion 030104 developmental biology Etiology GH deficiency GHRH-arg brain tumors transition young adults IGHD business GH Deficiency Hormone |
| Zdroj: | Frontiers in Endocrinology Frontiers in Endocrinology, Vol 10 (2019) |
| Popis: | Background: Re-testing for GH secretion is needed to confirm the diagnosis of GH deficiency (GHD) after adult height achievement in childhood-onset GHD (COGHD).Aim: To define the cut-off of GH peak after retesting with GH-releasing hormone plus arginine (GHRHarg) in the diagnosis of permanent GHD in COGHD of different etiology.Patients and methods: Eighty-eight COGHD (median age 17.2 y), 29 idiopathic GHD (IGHD), 44 cancer survivors (TGHD) and 15 congenital GHD (CGHD) were enrolled in the study; 54 had isolated GHD (iGHD) and 34 had multiple pituitary hormone deficiencies (MPHD). All were tested with insulin tolerance test (ITT) and GHRHarg. IGHD with a GH response to ITT >= 6 mu g/L were considered true negatives and served as the control group, and patients with a GH response = 6 mu g/L and 42 with GH peak = 6 mu g/L. ROC analysis based on the etiology indicated the best diagnostic accuracy for peak GH cutoffs after GHRHarg of 25.3 mu g/L in CGHD, 15.7 in TGHD, and 13.8 in MPHD, and for IGF-1 SDS at -2.1 in CGHD, -1.5 in TGHD, and -1.9 in MPHD.Conclusions: Our findings indicate that the best cut-off for GH peak after retesting with GHRHarg changes according to the etiology of GHD during the transition age. Based on these results the diagnostic accuracy of GHRHarg remains questionable. |
| Databáze: | OpenAIRE |
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