title: Urinary growth hormone level and insulin-like growth factor-1 standard deviation score (IGF-SDS) can discriminate adult patients with severe growth hormone deficiency.
abstract: Adult growth hormone (GH) deficiency (AGHD) in Japan is diagnosed based on peak GH concentrations during GH provocative tests such as GHRP-2 stimulation test. In this study, we aimed to evaluate the ability of serum insulin-like growth factor-1 (sIGF-1) and urinary GH (uGH) at the time of awakening to diagnose AGHD. Fifty-nine patients with pituitary disease (32 men and 27 women; age 20-85 y (57.5 ± 15.5, mean ± SD) underwent GHRP-2 stimulation and sIGF-1 testing. Thirty-six and 23 patients were diagnosed with and without severe AGHD, respectively based on a peak GH response of <9 ng/mL to GHRP-2 stimulation. Serum IGF-1 was evaluated as a standard deviation score (IGF-1 SDS) based on age and sex. We determined whether uGH levels in urine samples from 42 of the 59 patients at awakening were above or below the sensitivity limit. We evaluated IGF-1 SDS and uGH levels in a control group of 15 healthy volunteers. Values for IGF-1 SDS were significantly lower in patients with, than without (-2.07 ± 1.77 vs.-0.03 ± 0.92, mean ± SD; p < 0.001) AGHD whereas the range of IGF-1 SDS substantially overlapped at > -1.4. IGF-1 SDS discriminated AGHD more effectively in patients aged ≤60 years. The χ2 test revealed a statistical relationship between uGH and AGHD (test statistic: 7.0104 ≥ χ2 (1; 0.01) = 6.6349). When IGF-1 SDS is < -1.4 or uGH is below the sensitivity limit, AGHD can be detected with high sensitivity.
authors.affiliation: Department of Neurosurgery, Teikyo University Chiba Medical Center, Ichihara 299-0111, Japan. hirohata-tky@umin.ac.jp
authors.forename: Toshio
authors.initials: T
authors.lastname: Hirohata
authors.forename: Nobuhito
authors.initials: N
authors.lastname: Saito
authors.forename: Koji
authors.initials: K
authors.lastname: Takano
authors.forename: So
authors.initials: S
authors.lastname: Yamada
authors.forename: Jae-Hyun
authors.initials: JH
authors.lastname: Son
authors.forename: Shoko M
authors.initials: SM
authors.lastname: Yamada
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakaguchi
authors.forename: Katsumi
authors.initials: K
authors.lastname: Hoya
authors.forename: Mineko
authors.initials: M
authors.lastname: Murakami
authors.forename: Akiko
authors.initials: A
authors.lastname: Mizutani
authors.forename: Hiroko
authors.initials: H
authors.lastname: Okinaga
authors.forename: Akira
authors.initials: A
authors.lastname: Matsuno
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019382:Human Growth Hormone / Q000172:deficiency* / Q000652:urine*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides; D010900:Pituitary Diseases / Q000150:complications
chemical_list: D009842:Oligopeptides; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; C091874:growth hormone-releasing peptide-2