Clinical Study Of Growth Hormone Stimulation Test In Patients With Short Stature

Background:Although the growth hormone provocation test is considered to be the gold standard for the diagnosis of growth hormone deficiency-type short stature,there is still controversy about the selection of the evaluation index.The growth hormone provocation test has poor repeatability,and a single drug provocation test is 15%False positive rate.At present,most of the researches on the diagnosis of growth hormone deficiency short stature are mainly based on the determination of the peak concentration of growth hormone provocation test,and there is not much research on other indicators.Different drugs stimulate the secretion of growth hormone in their principles and ways,but there are relatively few studies on the pros and cons of growth hormone provocation tests.Purpose:compare growth hormone provocation tests stimulated by different drugs,obtain single test,combined test provocation intensity and provocation positive rate,analyze the influencing factors of growth hormone provocation test diagnostic indicators,and explore new ways to diagnose growth hormone deficiency short stature New indicators.Method:Selected from August 2011 to August 2020 in the Department of Endocrinology,Shandong University Qilu Hospital,the age≤18 years old,height,weight,blood test indicators,etc.are in line with the "Guidelines for the diagnosis and treatment of short stature children" on the diagnosis of short stature in children In 91 patients with indicators,the clinical data of children with short stature were collected by retrospective analysis method,and the clinical data of the children were analyzed using statistical analysis software such as SPSS23.0 and Grahpad 8.0.Results:The positive rate of insulin hypoglycemia test was 85.71%,the positive rate of levodopa test was 84.21%,the positive rate of arginine test was 57.14%;the peak growth hormone concentration of insulin hypoglycemia test was positive with the concentration of IGF-1 Correlation,r=0.342,P=0.014;the peak growth hormone concentration in the levodopa test is positively correlated with the concentration of IGF-1,r=0.340,P=0.043,the peak growth hormone concentration in the arginine test is not related to the concentration of IGF-1 Correlation:The area under the curve of the growth hormone challenge test time-growth hormone concentration curve is related to IGF-1,and has a linear relationship with the peak growth hormone concentration;when the GH concentration peak tangent point is 10ng/mL,the area under the curve is critical The values are:arginine test 494.75,insulin hypoglycemia test 481.9,levodopa test 400.6.Conclusions and significance:(1)In this study,the positive rate of insulin hypoglycemia test,levodopa test,and peak GH concentration are in good agreement,and the peak GH concentration is in good agreement with IGF-1;(2)The peak GH concentration of the arginine test has great variability,and the diagnostic value of the test needs to be reassessed;(3)AUC has the potential to become one of the indicators for the diagnosis of GHD.