Abstract
In 22 short-statured children GH was determined every 20 minutes from 20:00 to 8:00 with continous EEC registration to demonstrate stage 4 sleep. Peak and mean GH values were analyzed. At 8:00 a bolus of 1 μg/kg GRF 1-44 was given and GH measured every 15 minutes. Group A (n=12) had been previously diagnosed as GH-deficient (GHD) (peak GH < 6 ng/ml in 2 independent tests, height and growth rate < -2 SDS). These children had been treated with GH for 1.5-12 years and were off treatment for>6 months when reexamined. Group B (n=2) had been diagnosed and treated as GHD but showed normal growth velocity after cessation of therapy. Both had reached Tanner III and might be classified as transient GHD. Group C consisted of 8 children in whom GH rose above 8 ng/ml in at least one conventional test.
Table 1 gives mean±SEM for chronological age (CA), bone age (BA), height (SDS) and growth velocity (cm/year), peak (P) and mean (M) GH values during sleep and peak GH after GRF (ng/ml). Individual values in group B.
Spontaneous growth correlated only with mean GH during sleep (r=0.45; p<0.05).
Conclusion: 1)Nocturnal GH profiles with EEC monitoring of sleep provide a physiologic method to assess GH status. 2)Diagnosis of GH deficiency should be reevaluated when entering puberty - especially in children with isolated GH deficiency.
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Holl, R., Hartmann, P., Heinze, E. et al. GH SECRETION DURING SLEEP AND GRF-STIMULATION IN GH-DEFICIENT AND SHORT NORMAL CHILDREN. Pediatr Res 20, 1189 (1986). https://doi.org/10.1203/00006450-198611000-00092
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DOI: https://doi.org/10.1203/00006450-198611000-00092