N Giannessi

GHRH-test in short children with "non classic" GH deficiency. A comparison with "classic" GH deficiency and short normal stature.

In this study GHRH-test has been performed (2 μg/Kg of an iv bolus of GHRH 1–44) sampling for GH measurement every 15 min over 2 hours in three groups of short children. Group 1 consisted of 10 subjects with classic GH deficiency (CGHD): GH response < 10 ng/ml to two conventional tests and 24-h mean GH concentration (MGHC) < 3 ng/ml; group 2 consisted of 16 subjects with non-classic GH deficiency (NCGHD): response > 10 ng/ml to at least one conventional test and MGHC < 3 ng/ml; group 3 consisted of 18 subjects with short normal stature: GH response > 10 ng/ml to at least one conventional test and MGHC >3 ng/ml. GH peak and area under the curve (AUC) values were significantly lower in group 1 than groups 2 and 3 and in group 2 than group 3. GH peak and AUC values statistically correlated with height, height velocity, bone age/chronological age ratio and MGHC. Six children in group 1,14 children in group 2 and all 18 children in group 3 showed after GHRH a GH peak > 10 ng/ml and were considered as ‘responders’. Considering only the responders, GH peak and AUC values were significantly lower in group 1 than groups 2 and 3 and in group 2 than group 3. In conclusion, our data have shown that 87% of children with NCGHD responded to a single bolus of GHRH with an increase in GH levels > 10 ng/ml and that their responses were intermediate compared to those of CGHD and short normal subjects.