Concepts in the diagnosis of adult growth hormone deficiency
Concepts in the diagnosis of adult growth hormone deficiency
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DOI：
10.1159/000110478
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发表时间：
2007-01-01
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影响因子：
--
通讯作者：
Biller, Beverly M. K.
中科院分区：
文献类型：
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作者：
Biller, Beverly M. K.
背景。-为了诊断生长激素缺乏症（GHD），必须将GH水平正常的个体与缺乏GH的个体区分开来。这需要了解这两组之间GH分泌和其他相关因素的差异。正常胰岛素样生长因子I（IGF-I）水平的存在并不一定排除GHD的诊断，而在具有三种或四种其他激素缺乏症并且没有会以其他方式降低IGF-I的状况的受试者中的低IGF-I水平可能足以做出诊断。激发试验是一种临床相关的试验方法，但并非所有使用的试验都具有可比的特异性和灵敏度。结论：胰岛素诱导的低血糖是诊断GHD的推荐试验，但在大多数组中，精氨酸-GH-释放激素试验在正常和低血糖受试者之间实现了相当的分离。使用大型监测数据库的未来研究可能会进一步扩大我们对GHD及其诊断概念的理解。版权所有（c）2007 S. Karger AG，巴塞尔。
Background.-To make a diagnosis of growth hormone deficiency (GHD), individuals with normal GH levels must be distinguished from those who are deficient. This requires an understanding of how GH secretion and other related factors differs between these two groups. The presence of a normal insulin-like growth factor I (IGF-I) level does not necessarily preclude a diagnosis of GHD, whereas a low IGF-I level in a subject with three or four other hormone deficiencies and no conditions that would otherwise lower IGF-I might be sufficient to make the diagnosis. Provocative testing is a clinically relevant method of testing, but not all tests in use have comparable specificity and sensitivity. Conclusions: Insulin-induced hypoglycemia is the recommended test to diagnose GHD, but the arginine-GH-releasing hormone test achieves comparable separation between normal and hypopituitary subjects in most groups. Future studies using large surveillance databases may further expand our understanding of concepts underlying GHD and its diagnosis. Copyright (c) 2007 S. Karger AG, Basel.