ESPE2024 Rapid Free Communications GH and IGFs (6 abstracts)
Incidence of false positive results of growth hormone stimulation tests in children with short stature – from theoretical background to clinical approach
Joanna Smyczyńska 1 , Maciej Hilczer 2 , Andrzej Lewiński 3,2 & Renata Stawerska 3,2
1Medical University of Lodz, Department of Pediatrics, Endocrinology, Diabetology and Nephrology, Lodz, Poland. 2Polish Mother's Memorial Hospital - Research iInstitute, Department of Endocrinology and Metabolic Diseases, Lodz, Poland. 3Medical University of Lodz, Department of Pediatric Endocrinology, Lodz, Poland
Diagnosis of growth hormone (GH) deficiency (GHD) requires direct confirmation by decreased GH peak in stimulation tests (GHST), with measurement of IGF-1 proposed as laboratory screening [Wit et al. 2020]. Taking into account the low incidence of GHD, theoretical incidence of false positive (FP) results of GHST is relatively high [Bright et al. 2022]. Performing two (or more) GHST in each patient decreases the FP rate. Retrospective analysis included data of 2590 children with short stature (1653 boys, 937 girls), age 10.3±3.5 years, in whom two different standard GHST with clonidine (Test 1) and with glucagon (Test 2) were performed. Patients with known chronic diseases or syndromes, were excluded. The two cut-offs for GH peak in GHST were considered: 10.0 µg/l (Analysis 1) and 7.0 µg/l (Analysis 2). Each negative test was considered as true (TN). Decreased GH peak in only one of two tests was always considered FP. Theoretical frequency of FP results of both GHST in the same patient was calculated using probability theory.
| Cut-off GH peak for GHST |
Test 1 TN Test 2 TN |
Test 1 TN Test 2 FP |
Test 2 TN Test 1 FP |
Tests 1 & 2 positive (TP or FP) |
| 10.0 µg/l | 528 (20.4%) | 772 (29.8%) | 282 (10.9%) | 1008 (38.9%) |
| 7.0 µg/l | 1038 (40.1%) | 815 (31.5%) | 285 (11.0%) | 452 (17.4%) |
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