title: Low dose of insulin for assessment of growth hormone and cortisol release in short children.
abstract: OBJECTIVE
  In 55 prepubertal children with growth failure, aged 8.62 +/- 2.89 years, we evaluated the efficacy of a test using only half the usual dose of insulin by comparing the results with those obtained during a classical arginine tolerance test, performed separately.
  
  
  METHODS
  The patients were randomly divided into two groups: group A consisting of 37 children received 0.05 U/kg insulin, while group B consisting of 18 patients received 0.1 U/kg insulin. Each child received the same dose of arginine per kg during the second test.
  
  
  RESULTS
  Serum growth hormone (GH) peak levels were significantly (p < 0.01) lower in children of group A (6.59 +/- 4.10 ng/ml) than in those of group B (10.12 +/- 5.80 ng/ml). No differences of GH peak levels were found in patients of the two groups after arginine infusion. The injection of 0.05 U/kg insulin induced a significantly (p < 0.0001) lower percent decrease of serum glucose than 0.1 U/kg. No difference of the percent increase of serum cortisol induced by insulin at 0.05 U/kg and 0.1 U/kg was observed.
  
  
  CONCLUSIONS
  The diagnosis of GH deficiency in children can be supported by a blunted GH response after two or more pharmacological stimuli including hypoglycaemia induced by only half the usual dose of insulin.
authors.affiliation: Pediatric Department, University of Pavia, Italy. mauro.bozzola@unipv.it
authors.forename: Mauro
authors.initials: M
authors.lastname: Bozzola
authors.forename: Patrizia
authors.initials: P
authors.lastname: Comoli
authors.forename: Elena
authors.initials: E
authors.lastname: Bozzola
authors.forename: Carmine
authors.initials: C
authors.lastname: Tinelli
authors.forename: Annalisa
authors.initials: A
authors.lastname: Marello
authors.forename: Milena
authors.initials: M
authors.lastname: Stabile
authors.forename: Alessandra
authors.initials: A
authors.lastname: Mazzola
authors.forename: Vittorio
authors.initials: V
authors.lastname: Locatelli
mesh_terms: D001120:Arginine; D002648:Child; D005260:Female; D006130:Growth Disorders / Q000175:diagnosis*; D019382:Human Growth Hormone / Q000172:deficiency*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000378:metabolism; D007003:Hypoglycemia; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D008297:Male; D012680:Sensitivity and Specificity
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D019382:Human Growth Hormone; D001120:Arginine; D006854:Hydrocortisone