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      The Diagnostic Value of Integrated Growth Hormone Secretion Studies Shorter than 24 Hours in Normal- and Short-Growing Children

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          Spontaneous growth hormone (GH) secretion is evaluated by measurement of the 24-hour integrated concentration of GH (24-hour IC-GH), a major diagnostic procedure, or by shorter protocols such as monitoring 6 h during sleep. We have evaluated several possibilities for shortening the procedure by comparing the results of an abbreviated procedure to the 24-hour IC-GH studies. The study population consisted of 50 children with classic GH deficiency (group GHD), determined by provocative testing, and 45 children who had a subnormal secretion of GH (group N), determined by low 24-hour IC-GH but normal GH provocative tests. Twenty-two children of normal height and stature served as a control group. All the children were prepubertal. while there was no overlap between the lower 5th percentile of the 24-hour IC-GH of the control subjects (3.3 µg/l) and the upper 97th percentile of the 24-hour IC-GHs of the N and GHD groups (2.9 and 2.7 µg/l, respectively), there was a considerable overlap between the IC-GH of control subjects and that of the GHD and N groups measured in all the abbreviated blood withdrawal protocols, except for the 10-hour daytime and the 12-hour nighttime protocols of the GHD patients. It should be noted that there was only a small overlap between the control and the GHD groups during the 12-hour daytime protocol. We have found that the longer the blood collection period the greater the sensitivity and the specificity. We conclude that the 24-hour IC-GH test is the best diagnostic tool for identifying children with subnormal GH secretion.

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          Author and article information

          Horm Res Paediatr
          Hormone Research in Paediatrics
          S. Karger AG
          03 December 2008
          : 38
          : 5-6
          : 250-255
          aPediatric Endocrine Unit, Kaplan Hospital, Rehovot, Israel; bDepartment of Pediatrics, University of Maryland School of Medicine, Baltimore, Md., USA
          182553 Horm Res 1992;38:250–255
          © 1992 S. Karger AG, Basel

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          Pages: 6
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