Introduction: There is still controversy for priming with sex steroid before GH testing.
Objective and hypotheses: We studied GH response to stimulation in 92 children >9 years with idiopathic short stature (HtSDS −2). They were divided randomly into two groups. Children in group 1 (n=50) were primed with premarin in girls and testosterone in boys and those in group 2 were not primed (n=42). All children were tested using standard clonidine test and their serum IGF1 factor-I concentration measured. Additionally the growth and GHIGF1 data of group 2 children were compared with those for 32 short children (HtSDS <−2) < age 9 years who were also non-primed before GH testing (group 3).
Results: Neither GH peak response to provocation nor IGF1 concentrations differed between the two groups with and without priming.
Discussion: Taking a cut-level of 10 μg/l for normal GH response to clonidine, priming with sex steroids did not significantly increase the percentage of patients with normal GH response (52%) vs non-priming (47%). IGF1 level did not show any significant difference among the two studied groups >9 yearS. The peak GH response to clonidine provocation did not differ before (n=42) vs after 9 years (n=32) of age.
|Age||HtSDS||Basal GH||Peak GH||IGF1||Free T4|
|Primed >9 years||Mean||12.0||−2.1||1.5||11.4||164.1||15.0|
|Non primed >9 years||Mean||12.5||−2.2||3.0||10.5||160.7||15.3|
|Non primed <9 years||Mean||7.2||−2.2||3.0||10.5||160.7||15.3|
Conclusion: In this randomized study priming with sex steroids before GH testing did not significantly increase the yield of diagnosing short patients with normal GH secretion. In addition, GH response to provocation did not vary significantly between young (<9 years) and old (>9 years) short children.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology