ESPE Abstracts

Background: The growth hormone (GH)/insulin-like growth factor 1 (IGF-1) axis is central to growth and metabolism. Growth hormone deficiency (GHD) in children can lead to metabolic disturbances and an increased risk of hypoglycemia. However, the response of blood glucose levels to glucagon in the presence of GHD compared to children with idiopathic short stature (ISS) is not well understood. This study aims to elucidate the glucose response to glucagon in these two conditions.

Methods: In a comparative study, 50 children with GHD and 50 with ISS, all with a height age z-score (HAZ) of less than -2, were administered an intramuscular injection of glucagon (0.1 mg/kg, maximum 1 mg). Blood glucose and GH levels were measured at baseline and at intervals post-injection (60, 90, 120, 150, and 180 minutes).

Results: Initial analysis revealed no significant difference in the glucose response to glucagon between GHD and ISS subjects. At 120 minutes, 4 children (8%) with GHD and 2 (4%) with ISS exhibited glucose levels below 3 mmol/L, which normalized spontaneously by 180 minutes. The GH peak response did not correlate with glucose levels at any measured time point. Mean glucose levels at 0, 60, 90-, 120-, 150-, and 180-minutes post-injection, as well as standard deviations (SD), are provided for both groups, alongside IGF-1 SDS and GH levels at corresponding time points.

Conclusion: The study suggests that children with GHD do not demonstrate a significantly altered glucose response to glucagon compared to their ISS counterparts within the acute setting of this test. Additionally, the occurrence of transient hypoglycemia post-glucagon does not appear to be influenced by the presence of GHD. Further research may be required to assess long-term metabolic effects of GHD and its management.