Nocturnal urinary growth hormone excretion in growth hormone-deficient children on and off growth hormone treatment.
Non-compliance has been reported as a major issue in growth hormone (GH) therapy. We explored the use of urinary GH (uGH) measurements to monitor the GH treatment of 18 children (aged 5-16 years) diagnosed as GH deficient on the basis of history, phenotype, auxology and peak GH concentration during 2 provocation tests of < 15 mU/l. Each child collected 5 consecutive overnight urine samples while on GH replacement schedules, then discontinued treatment for 2 days and collected a further 5 urine samples. The mean mass of uGH excreted on treatment (8.6 ng, range 3.6-13.0 ng) was significantly greater than that off treatment (1.2 ng, range 0.6-2.7 np; p < 0.01). All uGH values on treatment exceeded the mean nocturnal uGH excretion of normal age- and sex-matched children. The clear distinction between uGH levels on and off GH treatment indicates that uGH measurement would determine whether two or more GH injections had been missed. A series of uGH estimates over a 2-week period may provide a realistic perspective on injection frequency.
Department of Child Health, University of Manchester, Royal Manchester Children's Hospital, UK.
A M
AM
Skinner
P E
PE
Clayton
G M
GM
Addison
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DA
Price
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006130:Growth Disorders / Q000188:drug therapy / Q000652:urine; D013006:Growth Hormone / Q000172:deficiency* / Q000627:therapeutic use / Q000652:urine*; D006801:Humans; D015592:Immunoradiometric Assay; D008297:Male; D010349:Patient Compliance
D013006:Growth Hormone