Somatotropic function in short stature: Evaluation by integrated auxological and hormonal indices in 214 children

F. Dammacco, M. F. Boghen, F. Camanni, M. Cappa, C. Ferrari, E. Ghigo, G. Giordano, S. Loche, F. Minuto, M. Mucci, E. E. Muller, A. Barreca, E. Bartolotta, J. Bellone, P. Borrelli, M. Bozzola, P. Bratta, F. Buzi, G. Cardinale

Research output: Contribution to journalArticlepeer-review

Abstract

GH secretion was evaluated in 214 children and adolescents (age, 5-16 yr; 160 males and 54 females) with short stature (height, ≤5th percentile) by assessing mean spontaneous overnight GH concentration (normal values, ≥3 and 3.9 μg/L for prepubertal and pubertal subjects, respectively) and responsiveness to stimulation with GH-releasing hormone combined with pyridostigmine (normal peak values, ≥20 μg/L). Plasma insulin-like growth factor-I (IGF-I) was also measured. According to their GH secretory status, children were grouped as follows: group I, 154 subjects with normal spontaneous and stimulated GH (43 slow-growing and 111 normally growing); group II, 39 subjects with low spontaneous, but normal stimulated, GH (27 slow-growing and 12 normally growing); group III, 18 slow-growing subjects with low spontaneous and stimulated GH; and group IV, 3 subjects with normal spontaneous, but low stimulated, GH. The following conclusions were drawn. 1) Forty-five slow-growing subjects (21% of the total sample) had GH deficiency; 27 (12.6%) belonged to group II (with a preserved GH pituitary reserve, denoting a hypothalamic dysfunction) and 18 (8.4%) to group III (with a reduced GH pituitary reserve). 2) Forty-three slow-growing children in group I had normal GH secretion but low mean IGF-I, which may indicate nutritional problems or a biologically hypoactive GH molecule. 3) The remaining 111 subjects in group I (52%), with normal growth rate, but low mean parental height, were considered as having familial and/or constitutional short stature. GH responses after pyridostigmine plus GH-releasing hormone were normal in all children with a normal growth rate. These findings show that besides clinical evaluation, the assessment of spontaneous GH secretion, GH pituitary reserve, and IGF-I concentration allows proper pathophysiological characterization of short stature. By this approach, the frequency of GH deficiency in our sample was higher than commonly thought.

Original languageEnglish
Pages (from-to)68-72
Number of pages5
JournalJournal of Clinical Endocrinology and Metabolism
Volume77
Issue number1
DOIs
Publication statusPublished - 1993

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

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