ESPE2024 Poster Category 3 GH and IGFs (21 abstracts)
Hamad General Hospital, Doha, Qatar
Introduction: Growth hormone (GH) deficiency in children with short stature poses significant diagnostic and therapeutic challenges. Sex steroid priming before GH stimulation tests (GHST) is a strategy employed to enhance the diagnostic accuracy for GH deficiency. However, the efficacy and impact of this approach remain subjects of debate.
Aim: This study aim ed to evaluate the effects of sex steroid priming on various growth and hormonal parameters in short stature children undergoing GH stimulation tests.
Methods: The study involved 40 children with short stature, randomized into two groups: 'With Priming' (n = 20) and 'Without Priming' (n = 20). Parameters assessed included age, height standard deviation score (HTSD), weight standard deviation score (WTSD), BMI standard deviation score (BMISD), growth velocity (GV), GVSD/HVSD, mid-parental height standard deviation (MPHSD), Tanner stage, peak GH level (GHST peak), insulin-like growth factor 1 (IGF1)
Results: Comparison between the two groups "With Priming" and "Without Priming"
Parameter | With Priming Group | Without Priming Group | P-value |
Age (years) | 11.30 (SD: 3.07) | 10.21 (SD: 2.61) | 0.2340 |
HTSD 1 (SD Score) | -2.46 (SD: 1.26) | -1.95 (SD: 1.20) | 0.1978 |
WTSD 1 (SD Score) | -0.12 (SD: 1.49) | -1.91 (SD: 0.26) | <0.0001 |
BMISD 1 (SD Score) | -1.07 (SD: 1.24) | 0.42 (SD: 1.25) | 0.0005 |
GV 1 (cm/year) | 3.93 (SD: 2.06) | 5.09 (SD: 3.03) | 0.1661 |
MPHSD | -1.10 (SD: 1.34) | -1.73 (SD: 4.93) | 0.5869 |
Tanner Stage | 1.56 (SD: 0.68) | 1.25 (SD: 0.43) | 0.0945 |
GHST Peak | 6.53 (SD: 5.57) | 5.18 (SD: 2.21) | 0.3234 |
IGF1SD | -0.31 (SD: 1.01) | 0.32 (SD: 1.36) | 0.1052 |
There is no significant difference in the average age, GV or HTSD 1 between the two groups. Mid-Parental Height Standard Deviation (MPHSD) did not differ significantly between the 2 groups (P = 0.5869). Tanner Stage was not different between the two groups (P = 0.0945). No significant difference in GH peak levels is observed (P = 0.3234). However, 4/20 and 8/20 were diagnosed with GHD (peak < 7 ng/dl) in the non-primed vs primed groups. IGF1SD did not differ between the two groups (P = 0.1052).
Conclusion: Sex steroid priming before GH stimulation tests in children with short stature appears to positively influence GH, however, the variability in response between primed and non-primed groups underscores the necessity for individualized diagnostic approaches.