| Diagnostic Significance of Urinary Growth Hormone Measurement in Patients with Growth Hormone Deficiency |
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No Hyun Kim, Woo Yeong Chung, Soon Yong Lee |
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Department of Pediatrics, Pusan Paik Hospital, College of Medicine, Inje University, Pusan, Kore |
| 성장호르몬 결핍성 왜소증에서 요중 성장호르몬 측정의 진단적 의의 |
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김노현, 정우영, 이순용 |
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인제대학교 의과대학 부산백병원 소아과학교실 |
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| Abstract |
Purpose
: To investigate the diagnostic significance of urinary growth hormone measurement and compare with the urinary GH values in different methods of urine collection, this study was performed in patients with short stature.
Methods
: Measurement of urinary GH excretion was performed in 9 children with complete growth hormone deficiency (GCD), in 19 children with partial growth hormone deficiency (GPD) and in 40 children with short stature whose height was below the third percentile for chronological age and reveal normal response to growth hormone porvocation test(insulin & L-dopa). The urinary GH was measured by a highly sensitive enzyme immunoassay, and serum GH was measured by IRMA(Immunoradiometric assay). Ten hour urine overnight collection was measured in all children and were compared with each one of two different methods inclding urine collection on early morning spot urine and during insulin stimulation test to determine the optimal method.
Results
: 1) The mean GH values of GCD group(3.21¡¾3.14ng/gCr, range 0-7.0ng/gCr) and GPD group(13.30¡¾7.26 ng/gCr , range 0-26.6 ng/gCr ) are lower than those of GHN group(22.21¡¾12.36 ng/gCr , range 4.6-52.1 ng/gCr ) in 10-hours overnight urine collection.
2) The result is consistant with GH excretion test of early morning spot urine collection and during insulin stimulation test. Comparison of the urinary GH values between GCD group and GPD group reveals that the former is lower in all kinds of tests cited above. But there is statistically significance only in 10-hour overnight urine collection.
3) The distribution of mean GH values of 1o-hour overnight urinecollection in GCD group reveals a tendency toward lower values(below 7 ng/gCr ) than in both GPD group(0-26 ng/gCr ) and GHN group(4.6-52.1 ng/gCr ). There is a wide distribution and considerable overlap between latter two groups.
4) There is a significant positive correlation among the methods of 10 hour overnight urine collection, early morning spot urine collection and urine collection during insulin stimulation test.
Conclusion
: These results suggest that the urinary growth hormone measurement is not enough to make a definite diagnostic value as a single test, since there is somewhat wide distribution especially in GHN group. But measurement of urinar GH value is simple and useful for the screening of GH deficiency in children with short stature. |
| Key Words:
Growth hormone deficiency, Urinary growth hormone measurement |
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