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Nathan Goodyear

Glucagon Stimulation Testing in Assessing for Adult Growth Hormone Deficiency: Current ... - 0 views

www.ncbi.nlm.nih.gov/...PMC3262627

glucagon stimulation test HGH GH human growth hormone growth hormone

shared by Nathan Goodyear on 04 Nov 14 - No Cached
  • Nathan Goodyear on 04 Nov 14
     
    the Glucagon Stim test is a useful alternative to the ITT for HGH deficiency evaluation.
Nathan Goodyear

Diagnosing Growth Hormone Deficiency in Adults - 0 views

www.hindawi.com/...972617

HGH GH human growth hormone growth hormone IGF-1

shared by Nathan Goodyear on 04 Nov 14 - No Cached
  • it is clear that serum IGF-1 and or IGFBP-3 can be normal in patients with undisputed GHD
  • Various investigators have reported normal IGF-1 values in 37–70% of GH deficient adults
  • The co-administration of arginine and GHRH (the combined test) is a powerful stimulus for GH production and has gained increasing acceptance as a useful method of diagnosing GHD [34]. This test has been advocated as a suitable alternative to ITT
  • ...12 more annotations...
  • The glucagon stimulation test (GST) is a reliable, safe alternative to the ITT in the diagnosis of GHD
  • It has also been suggested that that even mildly increased BMI (25–30 kg/m2) can result in diminished stimulated GH production in 13% of healthy subjects
  • Obesity, particularly marked obesity, is associated with blunted GH secretion in response to provocative stimuli
  • An intravenous infusion of arginine (0.5 g/kg body weight) together with an intravenous bolus of GHRH (1 mcg/kg body weight) is administered [30]. Serum samples for GH are then obtained every 15–30 minutes for two hours.
  • GH levels are higher during the luteal phase in comparison with the follicular phase of the cycle
  • Corneli et al. have defined BMI-specific cut-off points for diagnosing adult-onset GHD using GHRH + arginine—11.5 ng/mL for those with BMI < 25 kg/m2, 8.0 ng/mL for BMI 25–30 kg/m2, 4.2 ng/mL for those with BMI > 30 kg/m2
  • Oral, in contrast to transdermal oestrogen, lowers IGF-1 levels and is associated with increased GH levels
  • Adequate pituitary replacement with thyroxine and hydrocortisone are needed for optimal GH production
  • one cannot rely on a low IGF-1 to diagnose GHD in women taking oral oestrogen preparations.
  • Numerous GH secretagogues are available with the insulin tolerance test being the gold standard and the glucagon stimulation test or the GHRH + arginine as acceptable alternatives
  • ain et al. found the GST to be at least as good as the ITT in provoking GH secretion
  • the GST is safe, with almost no contraindications, it causes nausea and sometimes vomiting in 15–20% of subjects
  • Nathan Goodyear on 04 Nov 14
     
    Nice, more recent analysis, of HGH testing.
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