[Prognostic value of the L-Dopa and clonidine GH stimulation tests in patients with endogenous growth hormone deficiency - retrospective analysis after discontinuation of treatment - own experience].
BACKGROUND
Assessment of growth hormone (GH) deficiency in short children is still limited with complicated and heterogeneous scheme of the diagnostic tests.


OBJECTIVE
was to estimate a prognostic importance of the GH stimulation tests (L-Dopa and clonidine) in patients with severe (sGHD) and partial growth hormone deficiency (pGHD). The results of growth hormone treatment (rhGH) were analyzed in the both groups.


METHODS
The study group consists of 41 children, which used to be treated with rhGH. An insulin test was performed and according to the results two subgroups were distinguished: sGHD - n=11 and pGHD - n=30.


RESULTS
Assessment of the growth velocity (GV) in the first year of therapy in the whole study group was 9.0+/-2.6 cm/years (GVSD=4.5+/-4.0). The final height (FH) in the whole group amounted to htSD=-1.2+/-1.1. In the whole group a statistically important negative correlation was found between max GH peakin the insulin test and GV during the first year of treatment (r=-0.32 p=0.039) and between maxGH peak in the insulin test and final height standard deviation score (r=-0.36; p=0.02). A significant positive correlation was detected between max GH peak in the insulin test and max GH peak in the L-Dopa test (r=0.35; p=0.03). No analogical correlation was observed in the clonidine test. A statistically important negative correlation was found between max GH peak in the L-Dopa test and patient's final height (r=-0.41; p=0.011). The final height was positively correlated with GV in the first year of treatment (r=0.42; p=0.005).


CONCLUSIONS
L-Dopa test provides better results in determining GH pituitary reserve than the clonidine test. Patients with sGHD responded better to treatment with rhGH and their final height corresponds more closely to the population norm. A prognostic factor connected with the final results of treatment is also the rate of GV in the first year of treatment.
Petriczko
Elzbieta
E
Klinika Pediatrii, Endokrynologii, Diabetologii, Chorób Metabolicznych i Kardiologii Wieku Rozwojowego Pomorskiej AM. petrela1@wp.pl
Szmit-Domagalska
Justyna
J
Horodnicka-Józwa
Anita
A
Walczak
Mieczysław
M
D000293:Adolescent; D001827:Body Height / Q000187:drug effects*; D005260:Female; D006130:Growth Disorders / Q000209:etiology / Q000517:prevention & control; D013006:Growth Hormone / Q000627:therapeutic use*; D019382:Human Growth Hormone / Q000172:deficiency* / Q000187:drug effects / Q000378:metabolism*; D006801:Humans; D007980:Levodopa / Q000378:metabolism*; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies
D019382:Human Growth Hormone; D007980:Levodopa; D013006:Growth Hormone