ESPE Abstracts

Different substances are used to confirm/deny growth hormone (GH) deficiency. One of them is Glucagon. The exact mechanism of glucagon's direct stimulation of growth hormone secretion is not known, its hypoglycemic effect and late effect against glucagon are used during the test. Thus, since glucagon is a counterinsular hormone, it raises blood sugar, correspondingly, the amount of insulin in the blood increases, and increased insulin, in turn, causes hypoglycemia. Hypoglycemia is a stimulating factor for GH secretion.

Purpose: in the present study, we investigated which hours are the most suitable for taking a blood sample for growth hormone.

Material and Methods: 49 stimulation tests performed. GH peak was obtained in 31% of the tests in the 2.5th hour, in 22% in the 3rd hour, in 22% in the 2nd hour, and in 10% in the 1.5th hour. In 100% of tests with a peak at 3 hours, the GH reading at 2.5 hours is lower than at 3 hours. Only 18% of those patients had 2.5 hour peak GH > 7 ng/ml. This suggests that tests stopped at 2.5 hours may lead to inadequate results. In 80% of the tests with a peak at 1.5 hours, the 1.5 and 2 hour samples showed the same result. A total of 20% of tests had GH < 7 ng/ml at 2 h, after peak levels at 1.5 h. The blood samples: 0` 90` 120` 150` 180` minutes are considered appropriate. A blood sample may not be taken at 0 if there is already a valid random basal growth hormone result. 200 tests were examined. Basal growth hormone > 2 ng/ml was detected in 25% of them. 12% of the tests were excluded from the study. In 60% of the selected tests, basal growth hormone was > 2 ng/ml. In 40% of the tests, basal hormone was > 4 ng/ml. In 35% of the group with basal hormone > 2 ng/ml the maximum peak was less than 7 ng/ml. 6% of the group with basal hormone > 4 ng/ml had a maximal peak of less than 7 ng/ml.

Conclusion: taking into account that 94% of patients with random basal growth hormone > 4 ng/ml have a peak > 7 ng/ml, it is possible to assume a peak indicator result for such patients even without stimulation test. This can prevent psychological distress and financial cost to the child and family.