scholarly journals Growth Hormone (GH) Secretion in Patients with Childhood-Onset GH Deficiency: Retesting after One Year of Therapy and at Final Height

2003 ◽  
Vol 59 (1) ◽  
pp. 7-15 ◽  
Author(s):  
M. Thomas ◽  
G. Massa ◽  
M. Maes ◽  
D. Beckers ◽  
M. Craen ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Gh Deficiency ◽  
Final Height ◽  
Childhood Onset ◽  
Gh Secretion ◽  
One Year

scholarly journals Inclusion and Withdrawal Criteria for Growth Hormone (GH) Therapy in Children with Idiopathic GH Deficiency—Towards Following the Evidence but Still with Unresolved Problems

2022 ◽  
Author(s):  
Joanna Smyczyńska
Keyword(s):  
Growth Hormone ◽  
Gh Deficiency ◽  
Final Height ◽  
Threshold Value ◽  
Reference Ranges ◽  
Gh Therapy ◽  
Gh Secretion ◽  
Accelerate Growth ◽  
Stimulation Tests ◽  
Definition Of

According to current guidelines, growth hormone (GH) therapy is strongly recommended in children and adolescents with GH deficiency (GHD) in order to accelerate growth rate and attain normal adult height. The diagnosis of GHD requires demonstration of decreased GH secretion in stimulation tests, below the established threshold value. Currently, GHD in children is classified as secondary insulin-like growth factor-1 (IGF-1) deficiency. Most of children diagnosed with isolated GHD presents with normal GH secretion at the attainment of near-final height or even in mid-puberty. The most important clinical problems, related to the diagnosis of isolated GHD in children and to optimal duration of rhGH therapy include: arbitrary definition of subnormal GH peak in stimulation tests, disregarding factors influencing GH secretion, insufficient diagnostic accuracy and poor reproducibility of GH stimulation tests, discrepancies between spontaneous and stimulated GH secretion, clinical entity of neurosecretory dysfunction, discrepancies between IGF-1 concentrations and results of GH stimulation tests, significance of IGF-1 deficiency for the diagnosis of GHD, a need for validation IGF-1 reference ranges. Many of these issues have remained unresolved for 25 years or even longer. It seems that finding solutions to them should optimize diagnostics and therapy of children with short stature.

The influence of growth hormone (GH) therapy on cardiac performance in patients with childhood onset GH deficiency

2005 ◽  
Vol 15 (2) ◽  
pp. 156-164 ◽  
Author(s):  
A. Minczykowski ◽  
M. Gryczynska ◽  
K. Ziemnicka ◽  
R. Czepczynski ◽  
J. Sowinski ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Gh Deficiency ◽  
Cardiac Performance ◽  
Childhood Onset ◽  
Gh Therapy

scholarly journals Influence of Growth Hormone (GH) Receptor Deletion of Exon 3 and Full-Length Isoforms on GH Response and Final Height in Patients with Severe GH Deficiency

2008 ◽  
Vol 93 (3) ◽  
pp. 974-980 ◽  
Author(s):  
Barbara Räz ◽  
Marco Janner ◽  
Vibor Petkovic ◽  
Didier Lochmatter ◽  
Andrée Eblé ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Gh Deficiency ◽  
Final Height ◽  
Full Length ◽  
Gh Receptor

Reproducibility of the growth hormone response to stimulation with growth hormone-releasing hormone plus arginine during lifespan

1996 ◽  
Vol 135 (5) ◽  
pp. 568-572 ◽  
Author(s):  
Maria Rosa Valetto ◽  
Jaele Bellone ◽  
Claudia Baffoni ◽  
Paola Savio ◽  
Gianluca Aimaretti ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Gh Deficiency ◽  
Normal Subjects ◽  
Individual Variability ◽  
Hormone Response ◽  
Female Age ◽  
Releasing Hormone ◽  
Gh Secretion ◽  
Subject Variability ◽  
Within Subject Variability

Valetto MR, Bellone J, Baffoni C, Savio P, Aimaretti G, Gianotti L, Arvat E, Camanni F, Ghigo E. Reproducibility of the growth hormone response to stimulation with growth hormone-releasing hormone plus arginine during lifespan. Eur J Endocrinol 1996;135:568–72. ISSN 0804–4643 The reliability and reproducibility of provocative stimuli of growth hormone (GH) secretion in the diagnosis of GH deficiency are still controversial both in childhood and in adulthood. The combined administration of GH-releasing hormone (GHRH) and arginine (ARG), which likely acts via inhibition of hypothalamic somatostatin release, is one of the most potent stimuli known so far and has been proposed recently as the best test to explore the maximal somatotrope capacity of somatotrope cells. However, it is well known that, usually, provocative stimuli of GH secretion suffer from poor reproducibility and that of the GHRH + ARG test has still to be verified. We aimed to verify the between- and within-subject variability of the GH response to the GHRH + ARG test in normal subjects during their lifespan as well as in hypopituitaric patients with GH deficiency (GHD). In 10 normal children (C: six male and four female, age 12.3 ± 0.9 years, body mass index (BMI) = 16.6 ± 0.7 kg/m2, pubertal stages I-III), 18 normal young adults (Y: ten male and eight female, age 31.1 ± 1.3 years, BMI = 21.4 ± 0.4 kg/m2), 12 normal elderly subjects (E: two male and ten female, age 74.4 ± 1.8 years, BMI= 22.6 ± 0.6 kg/m2) and 15 panhypopituitaric GH-deficient patients (GHD: nine male and six female, age 40.9 ± 4.1 years, BMI= 22.7 ± 1.0 kg/m2), we studied the inter- and intra-individual variability of the GH response to GHRH (1 μg/kg iv) + ARG (0.5 g/kg iv) in two different sessions at least 3 days apart. The GH responses to GHRH + ARG in C (1st vs 2nd session: 61.6 ± 8.1 vs 66.5 ± 9.4 μg/l), Y (70.4 ± 10.1 vs 76.2 ± 10.7 μg/l) and E (57.9 ± 14.8 vs 52.1 ± 8.0 μg/l) were similar and reproducible in all groups. The somatotrope responsiveness to GHRH + ARG also showed a limited within-subject variability (r = 0.71, 0.90 and 0.89 and p < 0.02, 0.0005 and 0.0005 for C, Y and E, respectively). Similarly in GHD, the GH response to the GHRH + ARG test showed a good inter- (1st vs 2nd session: 2.3 ± 0.5 vs 2.2 ± 0.6 μg/l) and intra-individual reproducibility (r = 0.70, p < 0.005). The GHRH + ARG-induced GH responses in GHD were markedly lower (p < 0.0005) than those in age-matched controls and no overlap was found between GH peak responses in GHD and normal subjects. In normal subjects, the GH response to GHRH + ARG is very marked, independent of age and shows limited inter- and intra-individual variability. The GH response to the GHRH + ARG test is strikingly reduced in panhypopituitaric patients with GHD, in whom the low somatotrope responsiveness is reproducible. Thus, these findings strengthen the hypothesis that GHRH + ARG should be considered the most reliable test to evaluate the maximal secretory capacity of somatotrope cells and to distinguish normal subjects from GHD patients in adulthood. E. Ghigo, Divisione di Endocrinologia, Ospedale Molinette, C.so Dogliotti 14, 10126, Torino, Italy

Growth hormone-releasing hormone in the diagnosis and treatment of growth hormone deficient children

1986 ◽  
Vol 113 (4_Suppl) ◽  
pp. S123-S129
Author(s):  
R.J.M. ROSS ◽  
A. GROSSMAN ◽  
G.M. BESSER ◽  
M.O. SAVAGE
Keyword(s):  
Growth Hormone ◽  
Linear Growth ◽  
Gh Deficiency ◽  
Venous Blood ◽  
Alternative Therapy ◽  
Normal Subjects ◽  
Growth Hormone Releasing Hormone ◽  
Releasing Hormone ◽  
Gh Secretion ◽  
Depot Preparations

ABSTRACT A growth hormone-releasing hormone (GHRH) has recently been extracted and synthesised, and appears to be identical to human hypothalamic GHRH. Immunoreactive GHRH is found in the venous blood of normal subjects and GH-deficient children, but is probably not hypothalamic in origin and therefore not important in GH regulation. GHRH is a potent specific stimulator of GH secretion in man, and provides a valuable diagnostic test in differentiating hypothalamic from pituitary causes of GH deficiency. Preliminary data suggests that GHRH may promote linear growth in some GH deficient children. GHRH may well prove an important alternative therapy for GH deficient children especially if depot preparations or intranasal administration prove effective.

The effects of treatment combining an agonist of gonadotropin-releasing hormone with growth hormone in pubertal patients with isolated growth hormone deficiency

1989 ◽  
Vol 120 (6) ◽  
pp. 795-799 ◽  
Author(s):  
Jean Edmond Toublanc ◽  
Claire Couprie ◽  
Philippe Garnier ◽  
Jean-Claude Job
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Final Height ◽  
Bone Age ◽  
Hormone Deficiency ◽  
Gnrh Analogue ◽  
Isolated Growth Hormone Deficiency ◽  
One Year ◽  
Long Acting

Abstract. The final height of patients treated with growth hormone for isolated growth hormone deficiency has, up to now, been subnormal, with a mean below −2 sd in the series reported, an insufficient height at the onset of puberty and a more or less accelerated bone maturation during puberty being two important factors of the poor results. A long-acting analogue of gonadoliberin, Trp6-GnRH, has been given to GH-treated patients with isolated growth hormone deficiency at the time they reached pubertal stage 2, in combination with unchanged doses of GH, for one year in 11 and for two years in 7 of them. It resulted in an increase in the height age/bone age ratio and a reduction of the height insufficiency for bone age. The increase was slight but significant after one year, and fair after two years, in spite of a reduced annual growth rate. Post-analogue follow-up in 5 patients with continued GH treatment showed a good development of growth and of puberty. It is concluded that combination of the long-acting Trp6-GnRH analogue and GH for 1–2 years in patients with isolated growth hormone deficiency whose puberty starts with a very insufficient height may be an appropriate way to improve their growth parameters. Studies with increased doses of GH or increased frequency of injections could help to optimize the results. Several years of follow-up are needed for demonstrating the results on final height.

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