TY - JOUR
T1 - A reappraisal of diagnosing GH deficiency in adults
T2 - Role of gender, age, waist circumference, and body mass index
AU - Colao, Annamaria
AU - Di Somma, Carolina
AU - Savastano, Silvia
AU - Rota, Francesca
AU - Savanelli, Maria Cristina
AU - Aimaretti, Gianluca
AU - Lombardi, Gaetano
N1 - Funding Information:
This work was partially supported by Grant 7492 from Regione Campania L.R. 41/94 1999 and Grant 2003069821 (2003) from the Italian Minister of Research and University in Rome.
PY - 2009/11
Y1 - 2009/11
N2 - Objective: The objective of the study was to reevaluate the diagnostic accuracy of GH peak after GHRH plus arginine test (GHRH+ARG) according to patients' age, body mass index (BMI), and waist circumference to diagnose GH deficiency (GHD). Outcome Measures: GH peak after GHRH+ARG and IGF-I levels reported as SD score. Subjects: Subjects included 408 controls (218 women, 190 men, aged 15-80 yr) and 374 patients with hypopituitarism (167 women, 207 men, aged 16-83 yr). Results: In the (elderly) healthy subjects 15-25 yr old (young), 26-65 yr old (adults) and older than 65 yr, GH cutoffs were 15.6, 11.7, and 8.5 μg/liter, 11.8, 8.1, and 5.5 μg/liter, and 9.2, 6.1, and 4.0 μg/liter, respectively, in the lean, overweight, and obese subjects. Waist circumference was the best predictor of GH peak (t = -7.6, P < 0.0001) followed by BMI (t = -6.7, P < 0.0001) and age (t = -5.7, P < 0.0001). Based on the old (<9.1 μg/liter) and new GH cutoff, 286 (76.5%) and 276 (73.8%) of 374 hypopituitary patients had severe GHD. The receiving-operator characteristic analysis showed GH cutoffs in line with the third percentile or slightly higher results so that the prevalence of GHD increased to 90.1%. Conclusions: The results of the current study show that waist circumference and BMI are the strongest predictors of GH peak after GHRH+ARG followed by age. However, the old cutoff value of 9.0 μg/liter was in line with the new cutoffs in 95% of patients.
AB - Objective: The objective of the study was to reevaluate the diagnostic accuracy of GH peak after GHRH plus arginine test (GHRH+ARG) according to patients' age, body mass index (BMI), and waist circumference to diagnose GH deficiency (GHD). Outcome Measures: GH peak after GHRH+ARG and IGF-I levels reported as SD score. Subjects: Subjects included 408 controls (218 women, 190 men, aged 15-80 yr) and 374 patients with hypopituitarism (167 women, 207 men, aged 16-83 yr). Results: In the (elderly) healthy subjects 15-25 yr old (young), 26-65 yr old (adults) and older than 65 yr, GH cutoffs were 15.6, 11.7, and 8.5 μg/liter, 11.8, 8.1, and 5.5 μg/liter, and 9.2, 6.1, and 4.0 μg/liter, respectively, in the lean, overweight, and obese subjects. Waist circumference was the best predictor of GH peak (t = -7.6, P < 0.0001) followed by BMI (t = -6.7, P < 0.0001) and age (t = -5.7, P < 0.0001). Based on the old (<9.1 μg/liter) and new GH cutoff, 286 (76.5%) and 276 (73.8%) of 374 hypopituitary patients had severe GHD. The receiving-operator characteristic analysis showed GH cutoffs in line with the third percentile or slightly higher results so that the prevalence of GHD increased to 90.1%. Conclusions: The results of the current study show that waist circumference and BMI are the strongest predictors of GH peak after GHRH+ARG followed by age. However, the old cutoff value of 9.0 μg/liter was in line with the new cutoffs in 95% of patients.
UR - http://www.scopus.com/inward/record.url?scp=70449135217&partnerID=8YFLogxK
U2 - 10.1210/jc.2009-1134
DO - 10.1210/jc.2009-1134
M3 - Article
SN - 0021-972X
VL - 94
SP - 4414
EP - 4422
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 11
ER -
