PMID- 8675565
OWN - NLM
STAT- MEDLINE
DCOM- 19960815
LR  - 20181130
IS  - 0021-972X (Print)
IS  - 0021-972X (Linking)
VI  - 81
IP  - 7
DP  - 1996 Jul
TI  - Somatostatin pretreatment enhances growth hormone (GH) responsiveness to 
      GH-releasing hormone: a potential new diagnostic approach to GH deficiency.
PG  - 2487-94
AB  - Despite the availability of numerous testing procedures to evaluate GH secretion 
      in short children, there is still controversy about the most reliable test in the 
      diagnosis of GH deficiency. We have recently demonstrated that in normal short 
      children, priming with the long-acting somatostatin analog. SMS 201-995 (SMS), 
      significantly potentiates their GH response to subsequent GHRH challenge. In the 
      present study, we used the combined SMS + GHRH test in patients with GH 
      deficiency to validate the hypothesis that this test would better discriminate 
      between normal short children and those with truly diminished GH secretion. We 
      studied 24 children classified into three groups according to their GH peak 
      response to up to four conventional tests: 1) children with normal short stature 
      and normal GH response (NSSA: GH peak > or = 10 micrograms/L, n = 6); 2) children 
      with normal short stature with borderline GH response (NSSB: GH peak > or = 7 
      micrograms/L but < 10 micrograms/L, n = 4); and 3) GH-deficient children (GHD: GH 
      peak < 7 micrograms/L, n = 14). Two study protocols were performed in all 
      subjects: SMS (1 microgram/kg, sc) was randomly administered or omitted (control 
      test) a 0800 h and GHRH (1 microgram/kg, iv) was given 5 h later. Plasma GH 
      levels were measured every 30 min from 0800 h until 2 h after the GHRH injection. 
      Pretreatment with SMS significantly augmented the GH peak response and the GH 
      area under the GH concentration curve over 2 h after GHRH injection in the NSSA 
      group, compared with control tests, but had no effect in the other two groups. 
      While there was wide overlap of individual peak GH values to both the 
      conventional tests and to the GHRH injection in the control test among the three 
      groups of children, pretreatment with SMS resulted in complete discrimination 
      between GHD and normal short children; the mean GH peak response to GHRH after 
      SMS pretreatment was 8- to 9-fold lower in the GHD subjects (5.2 +/- 0.8 
      micrograms/L) compared with both the NSSA (44.0 +/- 14.3 micrograms/L; P < 0.01) 
      and NSSB (42.9 +/- 5.0 micrograms/L; P < 0.01) groups and, more importantly, 
      there was no overlap in the individual GH responses between GHD and normal short 
      children. These results demonstrate that the combined SMS + GHRH test clearly 
      discriminates normal short children from those with GHD. In view of its testing 
      economy, safety, and accuracy, this combined test could become the test of choice 
      to establish a diagnosis of GH deficiency in the slowly growing child.
FAU - Tzanela, M
AU  - Tzanela M
AD  - Department of Pediatrics, McGill University, Montreal, Quebec, Canada.
FAU - Guyda, H
AU  - Guyda H
FAU - Van Vliet, G
AU  - Van Vliet G
FAU - Tannenbaum, G S
AU  - Tannenbaum GS
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Clin Endocrinol Metab
JT  - The Journal of clinical endocrinology and metabolism
JID - 0375362
RN  - 0 (Blood Glucose)
RN  - 0 (Hormones)
RN  - 67763-96-6 (Insulin-Like Growth Factor I)
RN  - 9002-72-6 (Growth Hormone)
RN  - 9034-39-3 (Growth Hormone-Releasing Hormone)
RN  - RWM8CCW8GP (Octreotide)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Blood Glucose/metabolism
MH  - Body Height
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Growth Hormone/*deficiency/*metabolism
MH  - *Growth Hormone-Releasing Hormone
MH  - Hormones/*administration & dosage
MH  - Humans
MH  - Insulin-Like Growth Factor I/metabolism
MH  - Male
MH  - Octreotide/*administration & dosage
EDAT- 1996/07/01 00:00
MHDA- 1996/07/01 00:01
CRDT- 1996/07/01 00:00
PHST- 1996/07/01 00:00 [pubmed]
PHST- 1996/07/01 00:01 [medline]
PHST- 1996/07/01 00:00 [entrez]
AID - 10.1210/jcem.81.7.8675565 [doi]
PST - ppublish
SO  - J Clin Endocrinol Metab. 1996 Jul;81(7):2487-94. doi: 10.1210/jcem.81.7.8675565.