Clonidine-stimulated growth hormone concentrations (cut-off values) measured by immunochemiluminescent assay (ICMA) in children and adolescents with short stature

• Published in: Clinics (São Paulo, Brazil) Brazil), 2016-04, Vol.71 (4), p.226-231
• Main Authors: de Fátima Borges, Maria, Teixeira, Flávia Carolina Cândida, Feltrin, Aline Karin, Ribeiro, Karina Alvarenga, Nascentes, Gabriel Antonio Nogueira, Resende, Elisabete Aparecida Mantovani Rodrigues, Ferreira, Beatriz Pires, Silva, Adriana Paula, Palhares, Heloísa Marcelina Cunha
• Format: Article
• Language: English
• Subjects: Adolescent; Adrenergic alpha-2 Receptor Agonists - pharmacology; Body Height; Case-Control Studies; Child; Child, Preschool; Clinical Science; Clonidine; Clonidine - pharmacology; Female; GH Deficiency; Growth Disorders - blood; Growth Disorders - diagnosis; Growth Disorders - etiology; Growth Hormone - blood; Growth Hormone - deficiency; Human Growth Hormone - blood; Humans; Idiopathic Short Stature; Immunoassay - methods; Insulin-Like Growth Factor I - analysis; Luminescent Measurements - methods; Male; MEDICINE, GENERAL & INTERNAL; Prospective Studies; ROC Curve; Short Stature
• ISSN: 1807-5932; 1980-5322; 1980-5322
• DOI: 10.6061/clinics/2016(04)09

To establish cut-off values for growth hormone concentrations using clonidine as a secretagogue and an immunochemiluminescent assay as the method of measurement and to analyze the response time as well as the influence of gender, nutritional status and pubertal stage. A total of 225 tests were performed in 3 patient groups, categorized as group 1 (normal), group 2 (idiopathic short stature) and group 3 (growth hormone deficiency). Among the 199 disease-free individuals, 138 were prepubertal, and 61 were pubertal. Clonidine (0.1 mg/m2) was orally administered, and the growth hormone level was measured by immunochemiluminescent assay. The growth hormone peak and the difference between the growth hormone peak and the baseline level were then analyzed. Statistical analyses were performed using Student's t-test or the Mann-Whitney test and Kruskal-Wallis test followed by Dunn's post hoc test. Cut-off values were determined using a receiver operating characteristic curve. Group 1 and group 2 had no difference in growth hormone peak, gender, body mass index standard deviation score, or pubertal stage. Group 3 exhibited a significantly lower growth hormone peak than the other groups did. The receiver operating characteristic curve demonstrated that growth hormone concentrations ≥ 3.0 ng/mL defined responsiveness to clonidine. In total, 3.02% of individuals in group 1 and group 2 were considered false positive, i.e., these children lacked growth hormone deficiency and had a peak below 3.0 ng/mL. Clonidine-stimulated growth hormone concentrations ≥3 ng/mL, as measured by immunochemiluminescent assay, suggest responsiveness to the stimulus regardless of gender, body mass index standard deviation score or pubertal stage.