A precocious GH peak at GHRH plus Arginine test in GH sufficient short children is predictive of a lower growth velocity

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 624-646-Growth: Clinical Trials & Observational Studies
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-639
Flavia Prodam*1, Matteo Castagno1, Simonetta Bellone2, Giulia Genoni1, Enza Giglione1, Agostina Marolda1, Antonella Petri1 and Gianni Bona1
1UniversitÓ del Piemonte Orientale, Novara, Italy, 2Univ of Piemonte Orientale, Novara, Italy
Introduction: In children, GH secretion is considered sufficient when at least one value is >20 ng/mL at the GHRH + Arginine (ARG) test. Because GH typically peaks at 45 minutes, we evaluated whether peak occurrence at one specific time is predictive of clinical outcomes in short stature children who are GH sufficient.


Subjects and methods: Children who performed a GHRH plus ARG test for short stature were retrospectively recruited. Inclusion criteria were: 1) a GH peak > 20 ng/ml; 2) Tanner stages within 1-3 stages; 3) 1 year growth velocity since the test execution; 4) born adequate for gestational age; 5) the absence of signs suggestive of syndromes. Primary outcomes were height standard deviation score (SDS), growth velocity (GV), GVSDS and IGF-I SDS.


Results: 228 subjects were recruited, by which 14 were excluded because they did not satisfy inclusion criteria. Of 214 subjects, 121 (56.5%) had a peak at 45’ min, 55 (25.7%) at 30’ min, and 38 (17.8%) at 60’ min. Subjects presented a peak at 30 min had lower height SDS (p<0.05), growth velocity (p<0.001), growth velocity SDS (p<0.001), and GH peak (p<0.05) than those had a peak at 45’ min. Subjects presented a peak at 30’ min had lower GV (p<0.001), and GVSDS (p<0.001), but higher GH peak (p<0.05) than those had a peak at 60’ min. No differences were shown between children with a peak at 45’ or 60’ min. No differences in Tanner stages, sex, IGF-I SDS were recorded among three groups.

Conclusion: A peak at 30 minutes at the GHRH + ARG test in children who are short and without GH deficiency may be predictive of lower growth velocity in the year of the test. Because arginine infusion stops at 30 minutes, a somatostatinergic higher tone could have a role in the clinical picture.

Nothing to Disclose: FP, MC, SB, GG, EG, AM, AP, GB

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm