Gender has to be taken into account in diagnosing adult growth hormone deficiency by the GHRH plus arginine test

Show full item record



Permalink

http://hdl.handle.net/10138/298051

Citation

Markkanen , H M , Pekkarinen , T , Hamalainen , E , Valimaki , M J , Alfthan , H V & Stenman , U-H 2017 , ' Gender has to be taken into account in diagnosing adult growth hormone deficiency by the GHRH plus arginine test ' , Growth Hormone & IGF Research , vol. 35 , pp. 52-56 . https://doi.org/10.1016/j.ghir.2017.07.002

Title: Gender has to be taken into account in diagnosing adult growth hormone deficiency by the GHRH plus arginine test
Author: Markkanen, Helene M.; Pekkarinen, Tuula; Hamalainen, Esa; Valimaki, Matti J.; Alfthan, Henrik V.; Stenman, Ulf-Hakan
Contributor: University of Helsinki, HUSLAB
University of Helsinki, University of Helsinki
University of Helsinki, HUSLAB
University of Helsinki, Clinicum
University of Helsinki, Clinicum
University of Helsinki, Clinicum
Date: 2017-08
Language: eng
Number of pages: 5
Belongs to series: Growth Hormone & IGF Research
ISSN: 1096-6374
URI: http://hdl.handle.net/10138/298051
Abstract: Objective: Data on the effect of gender on the interpretation of the GHRH plus arginine stimulation test (GHRH + ARG test) is controversial. We validated the GHRH + ARG stimulation test in control subjects and patients with organic or idiopathic pituitary disease and a suspicion of adult growth hormone deficiency (AGHD) using the Immulite 2000 XPi GH assay. Design: We studied 126 apparently healthy adults (median age 38.8 years) and 34 patients with a suspicion of AGHD (median age 42.2 years). Identification of AGHD with the GHRH + ARG test was investigated with commonly accepted BMI-related consensus cut-off limits for peak GH concentrations. Serum samples collected during the GHRH + ARG test were analysed for GH in 2014-2015. Serum IGF-1 concentrations were studied as a reference. Results: In 14 of 65 (22%) control males the GH peak value was below the BMI-related cut-off limits for GH sufficiency indicating a false diagnosis of AGHD. All control females had a normal GHRH + ARG response. Median peak GH response was significantly (p <0.001) higher in female (39.3 mu g/L) than in male controls (21 mu g/L). According to consensus cut-offs all but one young female patient had a deficient response compatible with a diagnosis of AGHD. Conclusions: The GH response to stimulation by GHRH + ARG is gender-dependent, being lower in healthy males than in females. Gender should be considered when defining cut-off limits for peak GH concentrations in the GHRH + ARG test. The presently used BMI-related cut-off levels will lead to a significant misclassification of males as GH deficient.
Subject: Adult GHD
GHRH plus ARG
Gender
BMI
BODY-MASS INDEX
(GH)-RELEASING HORMONE
REPLACEMENT THERAPY
ENDOCRINE-SOCIETY
PROVOCATIVE TESTS
CUTOFF LIMITS
I LEVELS
STIMULATION
ADOLESCENTS
SECRETION
3121 General medicine, internal medicine and other clinical medicine
3111 Biomedicine
Rights:


Files in this item

Total number of downloads: Loading...

Files Size Format View
1_s2.0_S1096637417300588_main.pdf 351.9Kb PDF View/Open

This item appears in the following Collection(s)

Show full item record