Growth hormone deficiency: permanence and diagnosis in young adults.
OBJECTIVE
To optimize the tools for diagnosing idiopathic growth hormone (GH) deficiency.


METHODS
We compared the data of 43 young adults treated for GH deficiency before and after GH treatment and puberty. Those with organic lesions were assigned to group 1 (n = 9), those with certain GH deficiency (n = 11) to group 2 and those with no criterion of certitude of GH deficiency to group 3 (n = 23).


RESULTS
Group 1 patients: the GH peaks at first [1.5 +/- (SE) 0.4 microg/l] and second (1.9 +/- 0.7 microg/l) evaluations before treatment were similar to those at the third evaluation (1.2 +/- 0.8 microg/l) after treatment. Group 2 patients: they had similar peaks (2.6 +/- 0.8, 2.9 +/- 0.5 and 5.5 +/- 1.4 microg/l). Group 3 patients: the peaks increased from 4.9 +/- 0.4 and 4.8 +/- 0.4 to 18.4 +/- 2.3 microg/l (p < 0.0001); 87% had a GH peak >10 microg/l at this evaluation. The plasma insulin-like growth factor 1 was initially below -2 z-score in 12/13 of these patients and similarly low in 4/17 patients at the third evaluation. The growth rates of the three groups before and their increase during the 1st year of treatment were similar.


CONCLUSIONS
Almost all patients with GH deficiency before puberty without criteria of certitude had a normal GH peak after puberty. Some of these patients probably had a transiently low GH secretion.
D000293:Adolescent; D000328:Adult; D000365:Age Determination by Skeleton; D001827:Body Height; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D019382:Human Growth Hormone / Q000172:deficiency* / Q000378:metabolism / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D010900:Pituitary Diseases / Q000150:complications / Q000175:diagnosis; D011627:Puberty
D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I