| IMPACT OF DIFFERENT CUT-OFF LIMITS OF PEAK GH AFTER GHRH-ARGININE STIMULATORY TEST, SINGLE IGF1 MEASUREMENT OR THEIR COMBINATION IN IDENTIFYING ADULT PATIENTS WITH GROWTH HORMONE DEFICIENCY. | |
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MedLine Citation:
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PMID: 21307143 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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ObjectiveTo evaluate the impact of different peak GH cut-offs after GHRH-Arg, IGF1 or their combination in identifying GHD.Design and Patients894 controls(used for normative IGF1 levels) and 302 patients with suspected GHD. Different peak GH cut-off limits[used by European or North American(4.1 μg/l) Endocrine societies, by HypoCCs(2.5 μg/l), or with 95% specificity(based on BMI), Method 1, 2, 3 or 4, respectively] and IGF1 were considered.MethodsPeak GH after GHRH-Arg and IGF1. ResultsDifferent peak GH cut-offs recognized different proportions of GHD(range, 24.8%-62.9%).Methods with high sensitivity(1 and 2) recognized higher proportions(95.5% and 92.5%, respectively) of GHD among patients with three pituitary hormone deficits(TH), whereas,Method 4(with high specificity) identified 96.7% normal subjects among those without pituitary hormone deficits(HD); Method4 identified only 75%GHD among patients with TH, and Method 1 a high proportion(40%) of GHD among subjects without HD. 82% patients with TH and 84.5% without HD were recognized as GHD or normal, respectively by IGF1. Among the remaining patients with TH and normal IGF1, 75% was recognized as GHD by Method1; among patients without HD and abnormal IGF1, 87.5% was identified as normal by Method4. Overall, combination of IGF1 and Method1 or Method4 identified 95.5%GHD among patients with TH and 98.1% normal subjects among those without HD.ConclusionsSingle peak GH cut-offs have limits to sharply differentiate GHD from normal subjects; IGF1 may be used for selecting patients to be submitted to the GHRH-arg test; which peak GH cut-off limits should be used for identifying healthy or diseased patients depends mainly on the clinical context. |
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Authors:
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Fausto Bogazzi; Luca Manetti; Martina Lombardi; Clara Giovannetti; Valentina Raffaelli; Claudio Urbani; Ilaria Scattina; Pasquale Pepe; Aldo Iannelli; Enio Martino; Giuseppe Rossi |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-2-9 |
Journal Detail:
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Title: European journal of endocrinology / European Federation of Endocrine Societies Volume: - ISSN: 1479-683X ISO Abbreviation: - Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-2-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9423848 Medline TA: Eur J Endocrinol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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F Bogazzi, Department of Endocrinology, University of Pisa, Pisa, 56124, Italy. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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