Short stature with normal growth hormone stimulation testing: lack of evidence for partial growth hormone deficiency or insensitivity.
OBJECTIVE
To test the hypothesis that children with short stature and peak stimulated GH (pGH) of 7-10 microg/l have partial GH deficiency and to test the hypothesis that short children with normal pGH but low IGF-I levels have partial GH deficiency or partial GH insensitivity.


METHODS
Retrospective analysis of the clinical and biochemical profiles of 76 children who underwent an evaluation for short stature (height < 5th percentile) that included two, sex steroid-primed GH stimulation tests.


RESULTS
Patients with pGH < 7 microg/l (n = 14) differed significantly from those with pGH > 7 microg/l (n = 62), having greater midparental height (MPH) SDS, a greater disparity between height SDS and MPH SDS, and lower IGF-I SDS. Patients with pGH of 7-10 microg/l (n = 12) did not have characteristics intermediate between those with pGH < 7 microg/l and those with pGH > or = 10 microg/l, but instead resembled those with pGH > or = 10 microg/l. Patients with pGH > or = 7 microg/l, but low IGF-I (< -2 SDS) (n = 5), did not show characteristics intermediate between those with pGH < 7 microg/l and those with pGH > or = 7 microg/l and normal IGF-I.


CONCLUSIONS
These data do not support either the hypothesis that children with pGH of 7-10 microg/l have partial GH deficiency or the hypothesis that children with normal pGH but subnormal IGF-I levels have partial GH deficiency or insensitivity.
Nwosu
Benjamin U
BU
Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
Coco
Marilena
M
Jones
Joy
J
Barnes
Kevin M
KM
Yanovski
Jack A
JA
Baron
Jeffrey
J
D000293:Adolescent; D000316:Adrenergic alpha-Agonists; D001120:Arginine; D001835:Body Weight / Q000502:physiology*; D002648:Child; D003000:Clonidine; D004393:Dwarfism, Pituitary / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D007328:Insulin; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D007980:Levodopa; D008297:Male; D012189:Retrospective Studies
D000316:Adrenergic alpha-Agonists; D007328:Insulin; D007980:Levodopa; D007334:Insulin-Like Growth Factor I; D001120:Arginine; D003000:Clonidine