Evaluation of growth hormone provocative tests in Egyptian children with growth hormone-related short stature.
Clonidine test cut-off of 8.48 ng/mL diagnosed growth hormone deficiency with 77.8% sensitivity
Evaluation of growth hormone provocative tests in Egyptian children with growth hormone-related short stature.
Diagnosing growth hormone deficiency (growth hormone deficiency) in children remains challenging because of the considerable variability in the results of growth hormone (growth hormone) provocative tests.
To evaluate the validity of different growth hormone provocative tests, determine the sampling time associated with the peak growth hormone response, and identify optimal growth hormone cut-off values for excluding growth hormone deficiency.
This cohort study included 50 children aged 5-16 years presenting with proportionate short stature.
the clonidine cutoff correctly identified about 4 in 5 children with true growth hormone deficiency
The clonidine stimulation test showed the highest median growth hormone level at 90 minutes, followed by the insulin-induced peak at 45 minutes and the levodopa peak at 60 minutes.
A statistically significant positive correlation was observed between the insulin-like growth factor-1 Z-score and the growth hormone level measured at 90 minutes during the clonidine test.
Receiver operating characteristic curve analysis demonstrated optimal growth hormone cut-off values of 7.54 ng/mL for the insulin test, 8.48 ng/mL for the clonidine test, and 4.63 ng/mL for the levodopa test.
Oral clonidine and levodopa stimulation tests appear to be useful and safe alternatives for diagnosing growth hormone deficiency, avoiding the risk of hypoglycemia associated with the insulin tolerance test.
Lower growth hormone peak cut-off values may improve the diagnostic performance of these provocative tests.