[Statistic study of 5,473 somatotropin secretion stimulation pharmacologic tests (n=9). Proposed weighting coefficient].
A total of 5,473 pharmacological provocative growth hormone release tests were carried out in 3,143 children. Mean age was 9 years 9 months (range 3-16 years) and mean bone age was 7 years 6 months (range 2-14 years). Tests were of 9 different types: 1) arginine (n = 625); 2) clonidine (n = 339); 3) insulin (n = 198); 4) ornithine (n = 162); 5) insulin + arginine (n = 203); 6) clonidine + betaxolol (n = 2,003); 7) L-dopa (n = 685); 8) glucagon = propranolol (n = 443); 9) glucagon + betaxolol (n = 815). All growth hormone determinations were performed using the same radioimmunoassay. Distribution of values obtained with each test was gausso-logarithmic. Mean peak levels with their 95% confidence limit were as follows: 1) 10.2 and 0.45; 2) 11.5 and 0.7; 3) 11.8 and 0.8; 4) 14.2 and 1.2; 5) 14.3 and 0.9; 6) 15.7 and 1.1; 7) 19.8 and 2.1; 8) 20.8 and 2.3; 9) 21.0 and 2.5. These data indicate low specificity, with up to two-fold differences in mean peak levels from one test to another; proportions of peaks under 10 ng/ml ranged from 29% to 69%. Thus, the rate of patients diagnosed with growth hormone deficiency may vary substantially according to the test used. To reduce these discrepancies, we suggest adjustment of test results using a weighting coefficient of 1) 1.9; 2) 1.48; 3) 1.4; 4) 1.16; 5) 1.06; 6) 1.01; 7) 0.73; 8) 0.69; 9) 0.66.
Rochiccioli
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Service de Pédiatrie, CHU Purpan, Toulouse.
Enjaume
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Tauber
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Pienkowski
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Oliver
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D000293:Adolescent; D000365:Age Determination by Skeleton; D001120:Arginine; D015784:Betaxolol; D002648:Child; D002675:Child, Preschool; D003000:Clonidine; D016001:Confidence Intervals; D003627:Data Interpretation, Statistical; D005260:Female; D005934:Glucagon; D006130:Growth Disorders / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D013006:Growth Hormone / Q000097:blood / Q000378:metabolism*; D006801:Humans; D007328:Insulin; D007980:Levodopa; D008297:Male; D016011:Normal Distribution; D009952:Ornithine; D011433:Propranolol; D011627:Puberty; D011863:Radioimmunoassay; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D007328:Insulin; D007980:Levodopa; D013006:Growth Hormone; D005934:Glucagon; D001120:Arginine; D011433:Propranolol; D009952:Ornithine; D003000:Clonidine; D015784:Betaxolol
Etude statistique de 5,473 tests de stimulation pharmacologique (n = 9) de la sécrétion somatotrope. Proposition d'un indice de pondération.