title: Clonidine-stimulated growth hormone concentrations (cut-off values) measured by immunochemiluminescent assay (ICMA) in children and adolescents with short stature.
abstract: OBJECTIVE
  To establish cut-off values for growth hormone concentrations using clonidine as a secretagogue and an immunochemiluminescent assay as the method of measurement and to analyze the response time as well as the influence of gender, nutritional status and pubertal stage.
  
  
  METHODS
  A total of 225 tests were performed in 3 patient groups, categorized as group 1 (normal), group 2 (idiopathic short stature) and group 3 (growth hormone deficiency). Among the 199 disease-free individuals, 138 were prepubertal, and 61 were pubertal. Clonidine (0.1 mg/m2) was orally administered, and the growth hormone level was measured by immunochemiluminescent assay. The growth hormone peak and the difference between the growth hormone peak and the baseline level were then analyzed. Statistical analyses were performed using Student's t-test or the Mann-Whitney test and Kruskal-Wallis test followed by Dunn's post hoc test. Cut-off values were determined using a receiver operating characteristic curve.
  
  
  RESULTS
  Group 1 and group 2 had no difference in growth hormone peak, gender, body mass index standard deviation score, or pubertal stage. Group 3 exhibited a significantly lower growth hormone peak than the other groups did. The receiver operating characteristic curve demonstrated that growth hormone concentrations ≥ 3.0 ng/mL defined responsiveness to clonidine. In total, 3.02% of individuals in group 1 and group 2 were considered false positive, i.e., these children lacked growth hormone deficiency and had a peak below 3.0 ng/mL.
  
  
  CONCLUSIONS
  Clonidine-stimulated growth hormone concentrations ≥3 ng/mL, as measured by immunochemiluminescent assay, suggest responsiveness to the stimulus regardless of gender, body mass index standard deviation score or pubertal stage.
authors.affiliation: Unidade de Endocrinologia Pediátrica, Divisão de Endocrinologia, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil.
authors.forename: Maria de Fátima
authors.initials: Mde F
authors.lastname: Borges
authors.affiliation: Unidade de Endocrinologia Pediátrica, Divisão de Endocrinologia, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil.
authors.forename: Flávia Carolina Cândida
authors.initials: FC
authors.lastname: Teixeira
authors.affiliation: Unidade de Endocrinologia Pediátrica, Divisão de Endocrinologia, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil.
authors.forename: Aline Karin
authors.initials: AK
authors.lastname: Feltrin
authors.affiliation: Unidade de Endocrinologia Pediátrica, Divisão de Endocrinologia, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil.
authors.forename: Karina Alvarenga
authors.initials: KA
authors.lastname: Ribeiro
authors.affiliation: Microbiologia e Imunologia, Instituto Federal do Triângulo Mineiro, Uberaba, MG, Brazil.
authors.forename: Gabriel Antonio Nogueira
authors.initials: GA
authors.lastname: Nascentes
authors.affiliation: Unidade de Endocrinologia Pediátrica, Divisão de Endocrinologia, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil.
authors.forename: Elisabete Aparecida Mantovani Rodrigues
authors.initials: EA
authors.lastname: Resende
authors.affiliation: Unidade de Endocrinologia Pediátrica, Divisão de Endocrinologia, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil.
authors.forename: Beatriz Pires
authors.initials: BP
authors.lastname: Ferreira
authors.affiliation: Unidade de Endocrinologia Pediátrica, Divisão de Endocrinologia, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil.
authors.forename: Adriana Paula
authors.initials: AP
authors.lastname: Silva
authors.affiliation: Unidade de Endocrinologia Pediátrica, Divisão de Endocrinologia, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil.
authors.forename: Heloísa Marcelina Cunha
authors.initials: HM
authors.lastname: Palhares
mesh_terms: D000293:Adolescent; D058647:Adrenergic alpha-2 Receptor Agonists / Q000494:pharmacology*; D001827:Body Height; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003000:Clonidine / Q000494:pharmacology*; D005260:Female; D006130:Growth Disorders / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D013006:Growth Hormone / Q000097:blood / Q000172:deficiency*; D019382:Human Growth Hormone / Q000097:blood*; D006801:Humans; D007118:Immunoassay / Q000379:methods; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008163:Luminescent Measurements / Q000379:methods; D008297:Male; D011446:Prospective Studies; D012372:ROC Curve
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D003000:Clonidine