| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Hoeck HC, Vestergaard P, Jakobsen PE, Laurberg P, Test of growth hormone secretion in adults: poor reproducibility of the insulin tolerance test. Eur J Endocrinol 1995;133:305–12. ISSN 0804–4643
The insulin tolerance test (ITT) is regarded as the most reliable provocative test in the diagnosis of growth hormone (GH) deficiency in adults. In the present study the test was evaluated by investigating the range of GH responses in normal adult males and females and the intra-individual reproducibility of the test. Sixteen healthy non-obese adults, eight males (median age 31.5 years) and eight females (median age 31.8 years) were tested twice with the ITT, with a minimum of 72 h between each test. The females were tested between day 3 and day 10 of their menstrual cycles. Adequate hypoglycemia was achieved in all cases with a median nadir blood glucose of 1.3 mmol/l (range 0.8–2.0). Growth hormone in serum was measured by immunoradiometric assay and low values were confirmed by a different assay. Median peak GH concentration responses to the ITT were: in males 27.9 µg/l, range 5.0–71.1 (test 1) and 30.5 µg/l, range 7.9–69.5 (test 2); and in females 9.0 µg/l, range 4.1–17.9 (test 1) and 8.4 µg/l, range 0.09–42.4 (test 2). The rise in GH concentration during the ITT was higher in males than in females. In the males, all stimulated GH values were 
5.0 µg/l. In the females, four out of 16 tests gave values below 5.0 µg/l and in one test the GH value was around the detection limit of the assays. There was poor reproducibility during repeated testing, with no correlation between the results of the two tests. The results did not correlate to the magnitude of the hypoglycemia. The results of this study illustrate the complexity of the regulation of GH secretion and indicate that the ITT is less useful for diagnosing GH deficiency in adults than previously anticipated. The diagnosis of GH deficiency in adults and especially in adult females should not be based on the results of a single ITT alone.
Hans C Hoeck, Department of Endocrinology, Aalborg Regional Hospital, Reberbansgade, DK-9000 Aalborg, Denmark
This article has been cited by other articles:
|
|
 |
|
  G. Corneli, C. Di Somma, F. Prodam, J. Bellone, S. Bellone, V. Gasco, R. Baldelli, S. Rovere, H. J. Schneider, L. Gargantini, et al. Cut-off limits of the GH response to GHRH plus arginine test and IGF-I levels for the diagnosis of GH deficiency in late adolescents and young adults Eur. J. Endocrinol., December 1, 2007; 157(6): 701 - 708. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Chihara, A. Shimatsu, N. Hizuka, T. Tanaka, Y. Seino, Y. Katofor, and the KP-102 Study Group A simple diagnostic test using GH-releasing peptide-2 in adult GH deficiency Eur. J. Endocrinol., July 1, 2007; 157(1): 19 - 27. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Brabant GH releasing peptide 2 test: the holy grail of testing GH deficiency? Eur. J. Endocrinol., July 1, 2007; 157(1): 29 - 30. [Full Text] [PDF]
|
|
|
|
 |
|
 K. H. Darzy, S. S. Pezzoli, M. O. Thorner, and S. M. Shalet Cranial Irradiation and Growth Hormone Neurosecretory Dysfunction: A Critical Appraisal J. Clin. Endocrinol. Metab., May 1, 2007; 92(5): 1666 - 1672. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. D. Murray, M. Bidlingmaier, C. J. Strasburger, and S. M. Shalet The Diagnosis of Partial Growth Hormone Deficiency in Adults with a Putative Insult to the Hypothalamo-Pituitary Axis J. Clin. Endocrinol. Metab., May 1, 2007; 92(5): 1705 - 1709. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V K B Prabhakar and S M Shalet Aetiology, diagnosis, and management of hypopituitarism in adult life. Postgrad. Med. J., April 1, 2006; 82(966): 259 - 266. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Corneli, C. Di Somma, R. Baldelli, S. Rovere, V. Gasco, C. G. Croce, S. Grottoli, M. Maccario, A. Colao, G. Lombardi, et al. The cut-off limits of the GH response to GH-releasing hormone-arginine test related to body mass index Eur. J. Endocrinol., August 1, 2005; 153(2): 257 - 264. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. V Haijma, P S. van Dam, W. R de Vries, I. Maitimu-Smeele, C. Dieguez, F. F Casanueva, and H. P F Koppeschaar The GHRH/GHRP-6 test for the diagnosis of GH deficiency in elderly or severely obese men Eur. J. Endocrinol., April 1, 2005; 152(4): 575 - 580. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. M. K. Biller, M. H. Samuels, A. Zagar, D. M. Cook, B. M. Arafah, V. Bonert, S. Stavrou, D. L. Kleinberg, J. J. Chipman, and M. L. Hartman Sensitivity and Specificity of Six Tests for the Diagnosis of Adult GH Deficiency J. Clin. Endocrinol. Metab., May 1, 2002; 87(5): 2067 - 2079. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. L. Hartman, B. J. Crowe, B. M. K. Biller, K. K. Y. Ho, D. R. Clemmons, and J. J. Chipman Which Patients Do Not Require a GH Stimulation Test for the Diagnosis of Adult GH Deficiency? J. Clin. Endocrinol. Metab., February 1, 2002; 87(2): 477 - 485. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. A. Lissett, S. Saleem, A. Rahim, B. M. D. Brennan, and S. M. Shalet The Impact of Irradiation on Growth Hormone Responsiveness to Provocative Agents Is Stimulus Dependent: Results in 161 Individuals with Radiation Damage to the Somatotropic Axis J. Clin. Endocrinol. Metab., February 1, 2001; 86(2): 663 - 668. [Abstract] [Full Text]
|
|
|
|
|
|
H. C. Hoeck, P. Vestergaard, P. E. Jakobsen, J. Falhof, and P. Laurberg Diagnosis of Growth Hormone (GH) Deficiency in Adults with Hypothalamic-Pituitary Disorders: Comparison of Test Results Using Pyridostigmine Plus GH-Releasing Hormone (GHRH), Clonidine Plus GHRH, and Insulin-Induced Hypoglycemia as GH Secretagogues J. Clin. Endocrinol. Metab., April 1, 2000; 85(4): 1467 - 1472. [Abstract] [Full Text]
|
|
|
|
|
|
M. Gasperi, G. Aimaretti, G. Scarcello, G. Corneli, C. Cosci, E. Arvat, E. Martino, and E. Ghigo Low Dose Hexarelin and Growth Hormone (GH)-Releasing Hormone as a Diagnostic Tool for the Diagnosis of GH Deficiency in Adults: Comparison with Insulin-Induced Hypoglycemia Test J. Clin. Endocrinol. Metab., August 1, 1999; 84(8): 2633 - 2637. [Abstract] [Full Text]
|
|
|
|
|
|
A. Hilding, K. Hall, I.-L. Wivall-Helleryd, M. Sääf, A.-L. Melin, and M. Thorén Serum Levels of Insulin-Like Growth Factor I in 152 Patients with Growth Hormone Deficiency, Aged 19-82 Years, in Relation to Those in Healthy Subjects J. Clin. Endocrinol. Metab., June 1, 1999; 84(6): 2013 - 2019. [Abstract] [Full Text]
|
|
|
|
 |
|
 E. E. Muller, V. Locatelli, and D. Cocchi Neuroendocrine Control of Growth Hormone Secretion Physiol Rev, April 1, 1999; 79(2): 511 - 607. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Cordido, T. Fernandez, T. Martinez, A. Peñalva, R. Peinó, F. F. Casanueva, and C. Dieguez Effect of Acute Pharmacological Reduction of Plasma Free Fatty Acids on Growth Hormone (GH) Releasing Hormone-Induced GH Secretion in Obese Adults with and without Hypopituitarism J. Clin. Endocrinol. Metab., December 1, 1998; 83(12): 4350 - 4354. [Abstract] [Full Text]
|
|
|
|
|
|
A. Juul, S. Møller, E. Mosfeldt-Laursen, M. H. Rasmussen, T. Scheike, S. A. Pedersen, K. W. Kastrup, H. Yu, J. Mistry, S. Rasmussen, et al. The Acid-Labile Subunit of Human Ternary Insulin-Like Growth Factor Binding Protein Complex in Serum: Hepatosplanchnic Release, Diurnal Variation, Circulating Concentrations in Healthy Subjects, and Diagnostic Use in Patients with Growth Hormone Deficiency J. Clin. Endocrinol. Metab., December 1, 1998; 83(12): 4408 - 4415. [Abstract] [Full Text]
|
|
|
|
|
|
G. Aimaretti, G. Corneli, P. Razzore, S. Bellone, C. Baffoni, E. Arvat, F. Camanni, and E. Ghigo Comparison between Insulin-Induced Hypoglycemia and Growth Hormone (GH)-Releasing Hormone + Arginine as Provocative Tests for the Diagnosis of GH Deficiency in Adults J. Clin. Endocrinol. Metab., May 1, 1998; 83(5): 1615 - 1618. [Abstract] [Full Text]
|
|
|
|
 |
|
 S. M. Shalet, A. Toogood, A. Rahim, and B. M. D. Brennan The Diagnosis of Growth Hormone Deficiency in Children and Adults Endocr. Rev., April 1, 1998; 19(2): 203 - 223. [Abstract] [Full Text]
|
|
|
|
|
|
M. Andersen, J. Hangaard, C. Hagen, G. Aimaretti, and E. Ghigo The Diagnosis of Growth Hormone Deficiency in Adults J. Clin. Endocrinol. Metab., October 1, 1997; 82(10): 3513 - 3514. [Full Text] [PDF]
|
|
|
|
|
|
A. Juul, K. W. Kastrup, S. A. Pedersen, and N. E. Skakkebak Growth Hormone (GH) Provocative Retesting of 108 Young Adults with Childhood-Onset GH Deficiency and the Diagnostic Value of Insulin-Like Growth Factor I (IGF-I) and IGF-Binding Protein-3 J. Clin. Endocrinol. Metab., April 1, 1997; 82(4): 1195 - 1201. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
