title: An audit of the laboratory interpretation of growth hormone response to insulin-induced hypoglycaemia in the assessment of short stature in children.
abstract: BACKGROUND
  Measurement of serum growth hormone (GH) concentration in response to insulin-induced hypoglycaemia remains an important investigation in the assessment of pituitary disease.
  
  
  METHODS
  In this audit, laboratories were presented with aliquots of sera with GH concentrations likely to be found in an insulin stress test (IST). They were invited to analyse the specimens for GH and comment on their results.
  
  
  CONCLUSIONS
  A number of laboratories appeared to be using out-of-consensus cut-off concentrations that sometimes were unrelated to the bias of their GH assay. The specimens were chosen to mimic those seen in an IST that was clearly not indicative of GH deficiency, so there was reasonable consensus in the interpretation of results. However, five laboratories (9.6%) did indicate that their results were equivocal.
authors.affiliation: United Kingdom National Quality Assessment Scheme for Peptide Hormones, Department of Clinical Biochemistry, Royal Infirmary, Edinburgh EH3 9YW, UK. ukneqas@ed.ac.uk
authors.forename: Andrew
authors.initials: A
authors.lastname: Ellis
authors.forename: John
authors.initials: J
authors.lastname: Seth
authors.forename: Ruth
authors.initials: R
authors.lastname: Al-Sadie
authors.forename: Julian H
authors.initials: JH
authors.lastname: Barth
mesh_terms: D000172:Acromegaly / Q000097:blood / Q000175:diagnosis*; D001827:Body Height; D002648:Child; D013006:Growth Hormone / Q000097:blood* / Q000172:deficiency / Q000627:therapeutic use; D006801:Humans; D007003:Hypoglycemia / Q000097:blood* / Q000139:chemically induced; D007328:Insulin; D008297:Male; D008485:Medical Audit; D011933:Reagent Kits, Diagnostic
chemical_list: D007328:Insulin; D011933:Reagent Kits, Diagnostic; D013006:Growth Hormone