A Reappraisal of Diagnosing GH Deficiency in Adults: Role of Gender, Age, Waist Circumference, and Body Mass Index

Objective: The objective of the study was to reevaluate the diagnostic accuracy of GH peak after GHRH plus arginine test (GHRH+ARG) according to patients’ age, body mass index (BMI), and waist circumference to diagnose GH deficiency (GHD). Outcome Measures: GH peak after GHRH+ARG and IGF-I levels re...

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Bibliographic Details
Published in:The journal of clinical endocrinology and metabolism 2009-11, Vol.94 (11), p.4414-4422
Main Authors: Colao, Annamaria, Di Somma, Carolina, Savastano, Silvia, Rota, Francesca, Savanelli, Maria Cristina, Aimaretti, Gianluca, Lombardi, Gaetano
Format: Article
Language:English
Subjects:
Adult
Arginine - blood
Biological and medical sciences
Blood Pressure
Body Mass Index
Cholesterol, HDL - blood
Endocrinopathies
Feeding. Feeding behavior
Female
Fundamental and applied biological sciences. Psychology
Growth Hormone - blood
Growth Hormone - deficiency
Humans
Hypopituitarism - blood
Hypopituitarism - physiopathology
Male
Medical sciences
Middle Aged
Potassium - blood
Reference Values
Risk Factors
Sex Characteristics
Sodium - blood
Vertebrates: anatomy and physiology, studies on body, several organs or systems
Vertebrates: endocrinology
Waist Circumference
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Summary:Objective: The objective of the study was to reevaluate the diagnostic accuracy of GH peak after GHRH plus arginine test (GHRH+ARG) according to patients’ age, body mass index (BMI), and waist circumference to diagnose GH deficiency (GHD). Outcome Measures: GH peak after GHRH+ARG and IGF-I levels reported as sd score. Subjects: Subjects included 408 controls (218 women, 190 men, aged 15–80 yr) and 374 patients with hypopituitarism (167 women, 207 men, aged 16–83 yr). Results: In the (elderly) healthy subjects 15–25 yr old (young), 26–65 yr old (adults) and older than 65 yr, GH cutoffs were 15.6, 11.7, and 8.5 μg/liter, 11.8, 8.1, and 5.5 μg/liter, and 9.2, 6.1, and 4.0 μg/liter, respectively, in the lean, overweight, and obese subjects. Waist circumference was the best predictor of GH peak (t = −7.6, P < 0.0001) followed by BMI (t = −6.7, P < 0.0001) and age (t = −5.7, P < 0.0001). Based on the old (
ISSN:0021-972X
1945-7197
DOI:10.1210/jc.2009-1134