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      Measurement of Urinary Growth Hormone

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          Abstract

          Using pharmacological tests or GH profiles, GH deficiency or active acromegaly can be diagnosed. However, it is impossible to discriminate within the continuum between ‘deficiency/insufficiency’ and ‘sufficient secretion’. The use of GH to improve growth velocity is based on 1 injection once a day. It is thus the total amount of GH which appears to be important for its growth-promoting effect. An assay of GH in urine allows to assess such GH ‘production’, even over a prolonged period of time. A radiometric two-step assay applicable to untreated urine is presented. Results for assessing the ‘GH status’ by measuring GH in 24-hour urine, first morning-void urine or timed urine samples are shown. The correlation between 24-hour plasma profiles and the simultaneously collected 24-hour urine is significant at p < 0.01. A correlation coefficient > 0.9 was found between timed urine samples (4 h) and the 120-min plasma GH values during GHRH stimulation tests. The night-to-night variation of urinary GH can be very important. It is advisable, therefore, to use the mean of several night urines. The correlation between the mean urinary GH of 5 nights to one 24-hour sample is significant at p < 0.01. An age-dependent increase in urinary GH is found in the pubertal age group. The percentile distribution of 24-hour and night urines for the age groups < 7 years, prepuberty and puberty is given (P<sub>50</sub> GH in ng/night, mean of 3 urines: < 7 years = 0.49, prepubertal = 0.75, pubertal = 1.3). The respective 24-hour excretions are: < 7 years = 1.59, prepubertal = 2.62, and pubertal = 4.1 ng/24h Testosterone treatment of delayed puberty dramatically increases endogenous GH production, as shown by the urinary output. The high GH dose used to treat girls with Turner’s syndrome is reflected in a urinary output which is very similar to that found in boys on testosterone treatment. No correlation could be found between the GH dose used as supplementary treatment and urinary output. Furthermore, during GH therapy, the intraindividual excretion varies largely. It is concluded that urinary GH reflects the circulating GH, timed samples show the corresponding plasma values, the mean of several night (first morning-void) urines is a useful tool for assessing the GH status. Although pulsatility is obviously not reflected in urine, the varying total amount of GH secreted is modulated by pulse amplitude, and this is reflected indirectly in urinary GH. Urinary GH can be used to monitor GH therapy or any therapy intended to impair or increase endogenous GH production.

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          Author and article information

          Journal
          HRE
          Horm Res Paediatr
          10.1159/issn.1663-2818
          Hormone Research in Paediatrics
          S. Karger AG
          978-3-8055-5290-5
          978-3-318-01979-7
          1663-2818
          1663-2826
          1990
          1990
          02 December 2008
          : 33
          : Suppl 4
          : 12-18
          Affiliations
          University Children’s Hospital, Basel, Switzerland
          Article
          181578 Horm Res 1990;33:12–18
          10.1159/000181578
          2245965
          © 1990 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 7
          Categories
          The Seville hGH Symposium

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