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Colao, A. et al.

Annamaria Colao, Carolina Di Somma, Silvia Savastano, Francesca Rota, Maria Cristina Savanelli, Gianluca Aimaretti, Gaetano Lombardi,

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 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 microg/liter, 11.8, 8.1, and 5.5 microg/liter, and 9.2, 6.1, and 4.0 microg/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 (<9.1 microg/liter) and new GH cutoff, 286 (76.5%) and 276 (73.8%) of 374 hypopituitary patients had severe GHD. The receiving-operator characteristic analysis showed GH cutoffs in line with the third percentile or slightly higher results so that the prevalence of GHD increased to 90.1%. CONCLUSIONS: The results of the current study show that waist circumference and BMI are the strongest predictors of GH peak after GHRH+ARG followed by age. However, the old cutoff value of 9.0 microg/liter was in line with the new cutoffs in 95% of patients.[1]

References

A reappraisal of diagnosing GH deficiency in adults: role of gender, age, waist circumference, and body mass index. Colao, A., Di Somma, C., Savastano, S., Rota, F., Savanelli, M.C., Aimaretti, G., Lombardi, G. J. Clin. Endocrinol. Metab. (2009) [Pubmed]

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