Differences in reproducibility and peak growth hormone responses to repeated testing with various stimulators in healthy adults
Differences in reproducibility and peak growth hormone responses to repeated testing with various stimulators in healthy adults
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DOI：
10.1054/ghir.1998.0085
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发表时间：
1999-02-01
影响因子：
1.4
通讯作者：
Laurberg, P
中科院分区：
文献类型：
--
作者：
Hoeck, HC;Jakobsen, PE;Laurberg, P
在健康成人中，GH对激发试验的反应在受试者之间是可变的，尽管GH刺激试验在诊断GH缺乏症中的重要性，但关于受试者内变异性的信息有限。我们调查和比较了一组健康对照受试者的不同GH刺激试验的变异性。在16名健康的非肥胖成年人中，进行了两项胰岛素耐量试验（ITT）（静脉注射0.15 IU/kg体重，血糖下降小于或等于2.2 mmol/l）和两项GHRH试验（静脉注射1 μ g/kg体重），和2个可乐定（CLO）（300 μ g p.o.）+ GHRH（60分钟后）测试进行了一夜禁食后的早晨。将吡啶斯的明（PD）（120 mg p.o.对31名健康成人进行两次GHRH + GHRH试验。观察到广泛的GH反应。在ITT和GHRH试验期间，均出现通常认为反映GH分泌状态受损的低值。试验1和2中的中位（范围）峰值GH反应为：（a）ITT：14.4 μ g/l（4.1-71.1）和14.0微克/升（0.09-69.5），（B）GHRH试验：21.7 μ g/l（0.71-56.2）和18.4微克/升（1.6-55.1）;（c）CLO + GHRH试验：57.4微克/升（22.9-209）和65.8微克/升（12.2-206）;（d）PD + GHRH试验：36.5 μ g/l变异系数（CV）分别为：ITT组58%、GHRH组45%、CLO + GHRH组46%、PD + GHRH组26%。GH峰值反应在所有试验中有显著差异（CLO + GHRH > PD + GHRH > GHRH > ITT）。在个体受试者中，不同刺激试验中的峰值GH反应之间无系统相关性。总之，我们发现，刺激的GH反应是高度可变的，在所有的测试，和峰值GH反应不同。患者的检测结果应根据检测特异性参考值进行评价，在解释单次检测中的低应答时应谨慎。(C)1999年丘吉尔利文斯通。
In healthy adults, GH responses to provocative testing are variable between subjects, Information on the intra-subject variability is limited, despite the importance attached to GH stimulation tests in the diagnosis of GH deficiency. We have investigated and compared the variability of different GH stimulation tests in a group of healthy control subjects. In 16 healthy non-obese adults, two insulin tolerance tests (ITT) (0.15 IU/kg body weight i.v. and a fall in blood glucose less than or equal to 2.2 mmol/l) two GHRH tests (1 mu g/kg body weight i.v.), and two clonidine (CLO) (300 mu g p.o.) + GHRH (60 min later) tests were performed in the morning after an overnight fast. A pyridostigmine (PD) (120 mg p.o. 60 min before GHRH) + GHRH test was performed twice in an extended group of 31 healthy adult subjects. A wide range of GH responses was observed. Both during the ITT and the GHRH test, low values in the range generally recognized to reflect impairment of GH secretory status were encountered. The median (range) peak GH responses in tests 1 and 2 were: (a) ITT: 14.4 mu g/l (4.1-71.1) and 14.0 mu g/l (0.09-69.5), (b) GHRH test: 21.7 mu g/l (0.71-56.2) and 18.4 mu g/l (1.6-55.1); (c) CLO + GHRH test: 57.4 mu g/l (22.9-209) and 65.8 mu g/l (12.2-206); (d) PD + GHRH test: 36.5 mu g/l (9.1-125) and 44.6 mu g/l (6.3-101), The coefficients of variation (CV) were: 58% (ITT), 45% (GHRH), 46% (CLO + GHRH) and 26% (PD + GHRH). The peak GH responses were significantly different in all tests (CLO + GHRH > PD + GHRH > GHRH > ITT). In the individual subject, there was no systematic correlation between the peak GH responses in the different stimulation tests. In conclusion, we found that the stimulated GH responses were highly variable in all tests, and that the peak GH responses differed. Test results in patients should be evaluated against test-specific reference values, and caution is justified in the interpretation of low responses in a single test. (C) 1999 Churchill Livingstone.