Growth hormone levels during sleep in normal and growth hormone deficient children

• Published in: Pediatrics (Evanston) 1971-12, Vol.48 (6), p.946-954
• Main Authors: Underwood, L E, Azumi, K, Voina, S J, Van Wyk, J J
• Format: Article
• Language: English
• Subjects: Adolescent; Arginine; Child; Child, Preschool; Dwarfism, Pituitary - blood; Dwarfism, Pituitary - diagnosis; Female; Growth Hormone - blood; Humans; Hypopituitarism - blood; Hypopituitarism - diagnosis; Insulin; Male; Methods; Pituitary Function Tests; Radioimmunoassay; Sleep
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.48.6.946

Plasma growth hormone levels were determined from samples drawn at 15-minute intervals during the first 2 hours of spontaneous, nocturnal sleep in 16 normal children, one nongrowth hormone deficient dwarf, and three children with hypopituitarism. Depth of sleep was assessed by continuous EEC monitoring. Daytime growth hormone responses to insulin-induced hypoglycemia were also assessed in most of these children and in a larger group of normal and hypopituitary children. In the normal children and in the nongrowth hormone deficient dwarf, increases in plasma growth hormone after the onset of the slow wave pattern on EEG were equivalent to those seen after insulin-induced hypoglycemia. No significant changes in growth hormone levels were seen in the hypopituitary patients. Interpretation of growth hormone levels in blood specimens obtained by serial sampling after the onset of deep sleep appears to be as reliable a method of assessing pituitary function as the levels resulting from insulin-induced hypoglycemia. Although growth hormone analysis of a single sample taken about 1 hour after the onset of deep sleep should exclude the diagnosis of growth hormone deficiency in as many as 70% of the nongrowth hormone deficient individuals, a positive diagnosis of hyposomatotropism must be based on either serial sampling during deep sleep or challenge with insulin and/or arginine.