ESPE2024 Poster Category 3 Late Breaking (83 abstracts)
Relevance of the hypoglycemic insulin stimulation test in 486 cases
Ahmed Salih Bendeddouche 1 , Soundous Chemlal 1 , Meryem Dali Youcef 1 , Khadidja Bouriche 1 , Djawida Senouci 1 , Wafa Mazari 1 , Djihane Benasla 1 , Sana Benchikh 1 , Mohamed Rafii Bouheraoua 1 , Wahiba Hamidi 2 , Chakib Boukli-Hacene 1 , Chahrazed Belgherbi 1 , Hanane Kadouci 1 , Raouida Ouahiani 1 , Hadjer Bezzaouya 1 , Rahma Hamini 1 & H.L. Belbachir 1
1University AbouBekr Belkaid, Faculty of Medicine, Tlemcen, Algeria. 2Liberal Pediatric Practice, Tlemcen, Algeria
Objective: Determine the relevance of the hypoglycemic insulin stimulation test for GH secretion in the context of the exploration of stature delay in children
Materials and Methods: This is a prospective study carried out during the year 2022, of 486 children followed for the management of failure to thrive in the pediatric department of CHU Tlemcen.
Inclusion criteria: SR or slowing of growth rate, delay in bone age (> 2 years), Difference of more than 1.5 SD / target height, absence of pubertal height peak
Exclusion criteria: Any RS explained by a chronic pathology: celiac, renal failure, hypothyroidism, IUGR, Constitutional bone disease, syndromic SR: Turner’s SD …
Results and discussion: We performed 302 tests after excluding 184 patients presenting the pathologies: 89% IUGR, 5% Turner syndrome, 6% other (renal pathology, adrenal insufficiency), A clear male predominance was observed since 61.3% were male. The most represented age group is (10-14 years old) or 44.4% and 62.5% of boys and 71.7% of girls had infantile puberty on the day of the test: parents worry about adolescence. Before puberty 74.8% of children had stature delay (<-2 SD), 54.4% of them had severe RSP (-3 SD),40% of patients had a difference of 2 corridors in the target size and 82% of patients had a CV less than 06cm/year, 60% of patients had a difference of more than 02 years between bone age and chronological age which confirms stature delay. The test was passed without incident In 78.8% of patients. Early hypoglycemia in 30.8% of cases at 15 min and in 58.9% of cases up to 30 min. The hypoglycemic nadir represented half of the initial glycemia in 79.8% of patients: 79.6% of total deficits, 82% of partial deficits and 73% non-deficit. The test was interpretative in 83.6% of cases. The results of the stimulation test: 52% had a total deficit, 16% partial, 5% non-deficit. Rate of IGF1 returning less than [-2DS] in: 86% of total deficits, 98% of partial deficits, 40% non-deficit
Conclusion: The hypoglycemic insulin stimulation test represents a relevant tool in our series since the hypoglycemic nadir was respected in 79.8% of patients including 79.6%: total deficits, 82%: partial deficits and 73%: non-deficit
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