30 December 2008
Improved screening for growth hormone deficiency using logical analysis data
Pierre LemaireBCDE, Nadia BraunerBCD, Peter HammerCD, Christine TrivinBC, Jean-Claude SouberbielleBC, Raja BraunerAEFMed Sci Monit 2009; 15(1): MT5-10 :: ID: 869515
Abstract
Background
The growth hormone (GH) Research Society proposed criteria based on auxological parameters (height, difference between target and actual heights, growth rate) to predict GH deficiency (GHD) followed by GH stimulation tests. These criteria are very sensitive but not specific enough. The objective of this study was to improve screening for GHD, so reducing the need for stimulation tests.
Material and Method
The patients were divided into three groups: Group 1 (n=54) with GHD and pituitary stalk interruption syndrome; Group 2 (n=104) with a normal GH peak after pharmacological and sleep tests; Group 3 (n=19) with transient GHD. The GHD diagnosis was based on the parameters proposed by the GH Research Society to evaluate the GH secretion, first alone and then plus plasma insulin-like growth factor (IGF) I concentrations. Data were analysed using the logical analysis of data framework.
Results
Screening can be achieved using a simple graph based on IGF I and the growth rate (GR): (1) all patients below a given line (GR < or =-7.3 - 1.3xIGF (SDS)) had GHD; (2) all but two patients above another given line (GR >-4.5 + 6.4/(IGF + 4.5) (SDS)) did not have GHD; (3) in-between, patients in a "gray area" cannot be diagnosed using only growth rate and IGF I. Most of the transient GHD were in or near the "gray area".
Conclusions
Short children can be screened for GHD using growth rate and IGF I. Magnetic resonance imaging can then be used to detect pituitary stalk interruption syndrome or a tumor.
Keywords: Magnetic Resonance Imaging, Longitudinal Studies, Pituitary Gland - pathology, Insulin-Like Growth Factor I - analysis, Immunoassay, Growth Hormone - deficiency, France, Dwarfism, Pituitary - diagnosis, Child, Preschool, Child, Adolescent
Editorial
01 April 2024 : Editorial
Editorial: Forty Years of Waiting for Prevention and Cure of HIV Infection – Ongoing Challenges and Hopes for Vaccine Development and Overcoming Antiretroviral Drug ResistanceDOI: 10.12659/MSM.944600
Med Sci Monit 2024; 30:e944600
In Press
05 Mar 2024 : Clinical Research
Role of Critical Shoulder Angle in Degenerative Type Rotator Cuff Tears: A Turkish Cohort StudyMed Sci Monit In Press; DOI: 10.12659/MSM.943703
06 Mar 2024 : Clinical Research
Comparison of Outcomes between Single-Level and Double-Level Corpectomy in Thoracolumbar Reconstruction: A ...Med Sci Monit In Press; DOI: 10.12659/MSM.943797
21 Mar 2024 : Meta-Analysis
Economic Evaluation of COVID-19 Screening Tests and Surveillance Strategies in Low-Income, Middle-Income, a...Med Sci Monit In Press; DOI: 10.12659/MSM.943863
10 Apr 2024 : Clinical Research
Predicting Acute Cardiovascular Complications in COVID-19: Insights from a Specialized Cardiac Referral Dep...Med Sci Monit In Press; DOI: 10.12659/MSM.942612
Most Viewed Current Articles
17 Jan 2024 : Review article
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
16 May 2023 : Clinical Research
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952