The treadmill exhausting test is not suitable for screening of growth hormone deficiency!
METHODS
We compared the growth hormone response to a modified exercise test--the treadmill exhausting test--to pharmacological stimulation tests in 77 children with short stature. Each child underwent the treadmill test to individual exhaustion and at least one pharmacological test for GH stimulation. To determine the point of individual exhaustion, the heart rate, workload and oxygen consumption were measured.


RESULTS
The mean +/- SEM peak GH concentration (ng/ml) in 47 small, normally growing children (group 1) was 16.1 +/- 1.3 in the pharmacological tests vs. 5.0 +/- 0.6 after a treadmill exhausting test. Thirty children with GH deficiency (group 2) had mean +/- SEM peak GH concentrations (ng/ml) of 5.5 +/- 0.5 in the pharmacological tests and 4.1 +/- 0.7 after physical exercise. The groups differed significantly in the pharmacological tests (p < 0.001) but not in the exhausting test. We found a 90% sensitivity but only a 11% specificity for the treadmill exhausting test compared to the diagnosis obtained by pharmacological testing.


CONCLUSIONS
We do not recommend the treadmill exhausting test in clinical practice of pediatric endocrinology at all.
Donaubauer
J
J
Clinical Chemistry and Molecular Diagnostics, Children's Hospital, University of Leipzig, Oststrasse 21-25, D-04317 Leipzig, Germany. juliandonaubauer@web.de
Kratzsch
J
J
Fritzsch
C
C
Stach
B
B
Kiess
W
W
Keller
E
E
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D000075202:Contraindications; D004734:Energy Metabolism; D005080:Exercise Test / Q000379:methods; D005221:Fatigue / Q000503:physiopathology*; D005260:Female; D006130:Growth Disorders / Q000175:diagnosis* / Q000503:physiopathology*; D013006:Growth Hormone / Q000097:blood / Q000172:deficiency*; D006801:Humans; D008297:Male
D013006:Growth Hormone