title: [Diagnostic value of the propranolol-exercise provocative test for growth hormone deficiency in children].
abstract: OBJECTIVE
  To assess the diagnostic value of the propranolol-exercise provocative test for growth hormone deficiency (GHD) in children.
  
  
  METHODS
  This study included 120 children who received both the insulin provocative test and the propranolol-exercise provocative test due to short stature between January 2009 and March 2013. Growth hormone (GH) levels in venous blood were measured before and after the provocative test. Peak GH <10 ng/mL was defined as negative stimulation, while peak GH ≥10 ng/mL was defined as positive stimulation. The children whose peak GH levels were <10 ng/ mL after both tests were diagnosed with GHD.
  
  
  RESULTS
  Twenty-nine (24.2%) of the 120 children with short stature were diagnosed with GHD. The positive rate in the insulin provocative test was 48.3%, versus 65.8% in the propranolol-exercise provocative test. The overall coincidence rate and positive coincidence rate of the two tests were 62.5% and 79.3%, respectively. The peak GH after the propranolol-exercise provocative test was significantly higher than that after the insulin provocative test (P<0.01). Peak GH occurred mostly at 30-60 minutes after the insulin provocative test, while that occurred mostly at 120 minutes after the propranolol-exercise provocative test. No adverse effects were observed in the propranolol-exercise provocative test.
  
  
  CONCLUSIONS
  Coincidence rates in stimulating the secretion of GH are high between the propranolol-exercise provocative test and the insulin provocative test. Compared with the insulin provocative test, the propranolol-exercise provocative test is more likely to stimulate the secretion of GH. GHD can be clinically diagnosed by the insulin provocative test combined with the propranolol-exercise provocative test.
authors.affiliation: Department of Pediatrics, Peking University Third Hospital, Beijing 100191, China. xuemeiw7886@sohu.com.
authors.forename: Fang-Yuan
authors.initials: FY
authors.lastname: Zheng
authors.forename: Xue-Mei
authors.initials: XM
authors.lastname: Wang
authors.forename: Xin-Li
authors.initials: XL
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015444:Exercise; D005260:Female; D019382:Human Growth Hormone / Q000097:blood / Q000172:deficiency*; D006801:Humans; D007328:Insulin; D008297:Male; D011433:Propranolol
chemical_list: D007328:Insulin; D019382:Human Growth Hormone; D011433:Propranolol