Glucagon stimulation test to assess growth hormone status in Prader-Willi syndrome.
GHRH-arginine test
Glucagon-stimulation test
Growth hormone deficiency
Prader–Willi
Journal
Journal of endocrinological investigation
ISSN: 1720-8386
Titre abrégé: J Endocrinol Invest
Pays: Italy
ID NLM: 7806594
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
14
05
2020
accepted:
16
07
2020
pubmed:
29
7
2020
medline:
12
10
2021
entrez:
29
7
2020
Statut:
ppublish
Résumé
Growth hormone deficiency (GHD) must be confirmed before starting treatment in adults with Prader-Willi syndrome (PWS). Most studies use the growth-hormone-releasing hormone plus arginine (GHRH-arginine) test. No data are available on the glucagon stimulation test (GST) in PWS. We compared the utility of fixed-dose (1 mg) GST versus GHRH-arginine test in diagnosing GHD. Adults and late adolescents with PWS underwent both tests on separate days. In the GHRH-arginine test, GHD was defined according to body mass index. In the GST, two cutoffs were analyzed: peak GH concentration < 3 ng/mL and < 1 ng/mL. For analyses, patients were divided into two groups according to body weight (≤ 90 kg and > 90 kg). We analyzed 34 patients: 22 weighing ≤ 90 kg and 12 weighing > 90 kg. In patients weighing ≤ 90 kg, the two tests were concordant in 16 (72.72%) patients (k = 0.476, p = 0.009 with GST cutoff < 3 ng/mL, and k = 0.450, p = 0.035 with GST cutoff < 1 ng/mL). In patients weighing > 90 kg, the two tests were not concordant with GST cutoff < 3 ng/mL, but were concordant in 11 (91.6%) patients (k = 0.833, p = 0.003) with GST cutoff < 1 ng/mL. GH peaks on the two tests correlated (r = 0.725, p = 0.008). Fixed-dose (1 mg) GST using a peak GH cutoff of < 3 ng/mL or < 1 ng/mL promises to be useful for screening for GHD in adults and late adolescents with PWS. However, in those weighing > 90 kg, the < 1 ng/mL cutoff seems better. Larger studies are necessary to establish definitive glucagon doses and cutoffs, especially in extremely obese patients.
Identifiants
pubmed: 32720093
doi: 10.1007/s40618-020-01367-6
pii: 10.1007/s40618-020-01367-6
pmc: PMC7878226
doi:
Substances chimiques
Human Growth Hormone
12629-01-5
Glucagon
9007-92-5
Growth Hormone-Releasing Hormone
9034-39-3
Arginine
94ZLA3W45F
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
621-629Subventions
Organisme : Instituto de Salud Carlos III (ES)
ID : PI-18/00734
Organisme : Pfizer Foundation (US)
ID : 2015/594
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