title: Diagnostic value of a ghrelin test for the diagnosis of GH deficiency after subarachnoid hemorrhage.
abstract: OBJECTIVE
  To determine the diagnostic value of a ghrelin test in the diagnosis of GH deficiency (GHD) shortly after aneurysmal subarachnoid hemorrhage (SAH).
  
  
  METHODS
  Prospective single-center observational cohort study.
  
  
  METHODS
  A ghrelin test was assessed after the acute phase of SAH and a GH-releasing hormone (GHRH)-arginine test 6 months post SAH. Primary outcome was the diagnostic value of a ghrelin test compared with the GHRH-arginine test in the diagnosis of GHD. The secondary outcome was to assess the safety of the ghrelin test, including patients' comfort, adverse events, and idiosyncratic reactions.
  
  
  RESULTS
  Forty-three survivors of SAH were included (15 males, 35%, mean age 56. 6 ± 11.7). Six out of 43 (14%) SAH survivors were diagnosed with GHD by GHRH-arginine test. In GHD subjects, median GH peak during ghrelin test was significantly lower than that of non-GHD subjects (5.4 vs 16.6, P=0.002). Receiver operating characteristics analysis showed an area under the curve of 0.869. A cutoff limit of a GH peak of 15 μg/l corresponded with a sensitivity of 100% and a false-positive rate of 40%. No adverse events or idiosyncratic reactions were observed in subjects undergoing a ghrelin test, except for one subject who reported flushing shortly after ghrelin infusion.
  
  
  CONCLUSIONS
  Owing to its convenience, validity, and safety, the ghrelin test might be a valuable GH provocative test, especially in the early phase of SAH.
authors.affiliation: Departments of Medicine - Endocrinology.
authors.forename: K
authors.initials: K
authors.lastname: Blijdorp
authors.forename: L
authors.initials: L
authors.lastname: Khajeh
authors.forename: G M
authors.initials: GM
authors.lastname: Ribbers
authors.forename: E M
authors.initials: EM
authors.lastname: Sneekes
authors.forename: M H
authors.initials: MH
authors.lastname: Heijenbrok-Kal
authors.forename: H J G
authors.initials: HJ
authors.lastname: van den Berg-Emons
authors.forename: A J
authors.initials: AJ
authors.lastname: van der Lely
authors.forename: F
authors.initials: F
authors.lastname: van Kooten
authors.forename: S J C M M
authors.initials: SJ
authors.lastname: Neggers
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D003940:Diagnostic Techniques, Endocrine / Q000009:adverse effects / Q000592:standards; D005260:Female; D054439:Ghrelin; D019382:Human Growth Hormone / Q000097:blood* / Q000172:deficiency*; D006801:Humans; D007018:Hypopituitarism / Q000175:diagnosis* / Q000453:epidemiology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology / Q000378:metabolism*
chemical_list: D054439:Ghrelin; D019382:Human Growth Hormone
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