Adding Glucagon-Stimulated GH Testing to the Diagnostic Fast Increases the Detection of GH-Sufficient Children.
Adding Glucagon-Stimulated GH Testing to the Diagnostic Fast Increases the Detection of GH-Sufficient Children.
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添加胰高血糖素刺激的GH测试中的诊断快速增加了GH充足儿童的检测。
DOI：
10.1159/000444678
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发表时间：
2016
影响因子：
3.2
通讯作者：
De Leon DD
中科院分区：
文献类型：
--
作者：
Hawkes CP;Grimberg A;Dzata VE;De Leon DD
对不明原因低血糖儿童的评估可能包括快速诊断，但低血糖期间生长激素（GH）浓度低并不是生长激素缺乏症（GHD）所特有的。本研究的目的是确定在快速诊断的情况下，胰高血糖素给药后的连续GH测量是否会增加未确诊为GHD的儿童的数量。在诊断禁食结束后胰高血糖素给予连续GH测量的儿童的回顾性图表回顾。在禁食研究结束时给予胰高血糖素，每30分钟测量生长激素，持续210分钟。在本系列的29名儿童中，只有3名（10%）在禁食结束时生长激素浓度高于7ng/ml，而在连续的生长激素测试后，这一数字增加了16名（55%）。生长激素浓度高于7ng/ml的样品百分比为：基线时为10%；25%, 39%, 41%, 41%, 33%, 43%， 0%每隔30分钟。在快速诊断后给药胰高血糖素后进行额外的生长激素测量可以提高对无GHD儿童的识别，从而节省不必要的生长激素刺激试验和潜在的生长激素治疗。
The evaluation of children with unexplained hypoglycemia may include a diagnostic fast, but a low growth hormone (GH) concentration during hypoglycemia is not specific for GH deficiency (GHD). The aim of this study was to determine if serial GH measurement following glucagon administration, in the setting of a diagnostic fast, would increase the number of children identified as not having GHD. Retrospective chart review of children who had serial GH measurements performed after glucagon administration at the end of a diagnostic fast. Glucagon was administered at the end of the fasting study and GH was measured every 30 minutes for 210 minutes. Of the 29 children in this series, only 3 (10%) had GH concentrations above 7ng/ml at the end of the fast, and this increased by 16 (55%) after serial GH testing. The percentage of samples with GH concentrations above 7ng/ml were: 10% at baseline; and 25%, 39%, 41%, 41%, 33%, 43%, and 0% every 30 minutes thereafter. Additional GH measurements after glucagon administration following a diagnostic fast can improve the identification of children without GHD and thereby save them unnecessary GH stimulation testing and potential GH treatment.