Provocative Tests in the Diagnosis of Childhood Onset Growth Hormone Insufficiency
Autor(a) principal: | |
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Data de Publicação: | 2014 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | por eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4878 |
Resumo: | Introduction: The incidence of short stature associated with growth hormone deficiency has been estimated to be about 1:4000 to 1:10000. It is the main indication for treatment with recombinant growth hormone.Objectives: The aims of the study were to evaluate the results of growth hormone stimulation tests and identify the growth hormone deficiency predictors.Material and Methods: A cross-sectional, analytical and observational study was conducted. We studied all the children and adolescents submitted to growth hormone pharmacological stimulation tests between January 2008 and May 2012. Growth hormone deficiency diagnosis was confirmed by two negatives growth hormone stimulation tests (growth hormone peak < 7 ng/ml). The statistical analysis was performed using student t-test, chi-square, Pearson correlation and logistic regression. Statistical significance determined at the 5% level (p ≤ 0.05).Results: Pharmacological stimulation tests were performed in 89 patients, with a median age of 10 [3-17] years. Clonidine (n = 85) and insulin tolerance test (n = 4) were the first growth hormone stimulation tests performed. Growth hormone deficiency was confirmed in 22 cases. In cases with two growth hormone stimulation tests, the growth hormone peak showed a moderate correlation (r = 0.593, p = 0.01). In logistic regression model height (z-score) and the growth hormone peak in first stimulation test were predictors of growth hormone deficiency diagnosis (each one unit increase in z-score decrease the growth hormone deficiency probability).Discussion: Measurement of IGF-1 cannot be used in diagnosing growth hormone deficiency.Conclusion: Auxological criteria associated with a positive test seems to be a reliable diagnostic tool for growth hormone deficiency.Keywords: Growth Disorders; Human Growth Hormone/blood. |
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Provocative Tests in the Diagnosis of Childhood Onset Growth Hormone InsufficiencyO Papel dos Testes de Estimulação Farmacológica no Diagnóstico da Deficiência de Hormona do Crescimento em Crianças e AdolescentesIntroduction: The incidence of short stature associated with growth hormone deficiency has been estimated to be about 1:4000 to 1:10000. It is the main indication for treatment with recombinant growth hormone.Objectives: The aims of the study were to evaluate the results of growth hormone stimulation tests and identify the growth hormone deficiency predictors.Material and Methods: A cross-sectional, analytical and observational study was conducted. We studied all the children and adolescents submitted to growth hormone pharmacological stimulation tests between January 2008 and May 2012. Growth hormone deficiency diagnosis was confirmed by two negatives growth hormone stimulation tests (growth hormone peak < 7 ng/ml). The statistical analysis was performed using student t-test, chi-square, Pearson correlation and logistic regression. Statistical significance determined at the 5% level (p ≤ 0.05).Results: Pharmacological stimulation tests were performed in 89 patients, with a median age of 10 [3-17] years. Clonidine (n = 85) and insulin tolerance test (n = 4) were the first growth hormone stimulation tests performed. Growth hormone deficiency was confirmed in 22 cases. In cases with two growth hormone stimulation tests, the growth hormone peak showed a moderate correlation (r = 0.593, p = 0.01). In logistic regression model height (z-score) and the growth hormone peak in first stimulation test were predictors of growth hormone deficiency diagnosis (each one unit increase in z-score decrease the growth hormone deficiency probability).Discussion: Measurement of IGF-1 cannot be used in diagnosing growth hormone deficiency.Conclusion: Auxological criteria associated with a positive test seems to be a reliable diagnostic tool for growth hormone deficiency.Keywords: Growth Disorders; Human Growth Hormone/blood.Introdução: A incidência da deficiência de hormona do crescimento é de 1:4000 a 1:10000, sendo a principal indicação para tratamento com hormona do crescimento recombinante.Objectivos: Avaliar os resultados dos testes de estimulação da hormona do crescimento e identificar factores preditivos para o diagnóstico da deficiência de hormona do crescimento.Material e Métodos: Estudo observacional, analítico e transversal. Foram analisados dados clínicos e auxológicos e os resultados dos exames de diagnóstico de crianças e adolescentes submetidos a testes de estimulação farmacológica da hormona do crescimento (01/01/2008 a 31/05/2012). O diagnóstico definitivo de deficiência de hormona do crescimento foi efectuado mediante dois testes com estímulos farmacológicos diferentes negativos (pico máximo da hormona do crescimento < 7 ng/mL) ou um teste negativo associado à presença de alterações anatómicas da região hipotálamo-hipofisária, observadas na ressonância magnética cerebral. Para análise estatística, foram realizados o testes de t student, do qui- quadrado, correlação de Pearson e a regressão logística. Foi considerado como nível de significância estatística (p) um valor igual ou menor que 0,05.Resultados: Realizaram-se testes de estimulação em 89 doentes, com mediana de idade igual a 10 [3-17] anos, 67% do sexo masculino e 77% pré-púberes. Os fármacos utilizados no primeiro teste de estimulação foram a clonidina (n = 85) e a insulina (n = 4). Foram diagnosticados 22 casos de deficiência de hormona do crescimento. Nos casos submetidos a dois testes, os valores máximos de hormona do crescimento apresentaram uma correlação moderada entre si (r = 0,593, p = 0,01). Verificou-se que as variáveis estatura (z-score) e pico máximo de hormona do crescimento obtido no primeiro teste têm valor preditivo no diagnóstico de deficiência de hormona do crescimento.Discussão: A determinação do IGF-1 não demonstrou ser preditor de deficiência de hormona do crescimento.Conclusão: Os testes de estimulação são uma ferramenta de diagnóstico da deficiência de hormona do crescimento e que devem ser enquadrados nos parâmetros clínicos e auxológicos.Palavras-chave: Alterações do Crescimento; Hormona do Crescimento Humano.Ordem dos Médicos2014-09-25info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4878oai:ojs.www.actamedicaportuguesa.com:article/4878Acta Médica Portuguesa; Vol. 27 No. 5 (2014): September-October; 587-592Acta Médica Portuguesa; Vol. 27 N.º 5 (2014): Setembro-Outubro; 587-5921646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4878https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4878/4059https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4878/4183https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4878/7299https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4878/7300Gonçalves, Jean-PierreCorreia, FilipaCardoso, HelenaBorges, TeresaOliveira, Maria Joãoinfo:eu-repo/semantics/openAccess2022-12-20T11:04:03Zoai:ojs.www.actamedicaportuguesa.com:article/4878Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:18:59.699299Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Provocative Tests in the Diagnosis of Childhood Onset Growth Hormone Insufficiency O Papel dos Testes de Estimulação Farmacológica no Diagnóstico da Deficiência de Hormona do Crescimento em Crianças e Adolescentes |
title |
Provocative Tests in the Diagnosis of Childhood Onset Growth Hormone Insufficiency |
spellingShingle |
Provocative Tests in the Diagnosis of Childhood Onset Growth Hormone Insufficiency Gonçalves, Jean-Pierre |
title_short |
Provocative Tests in the Diagnosis of Childhood Onset Growth Hormone Insufficiency |
title_full |
Provocative Tests in the Diagnosis of Childhood Onset Growth Hormone Insufficiency |
title_fullStr |
Provocative Tests in the Diagnosis of Childhood Onset Growth Hormone Insufficiency |
title_full_unstemmed |
Provocative Tests in the Diagnosis of Childhood Onset Growth Hormone Insufficiency |
title_sort |
Provocative Tests in the Diagnosis of Childhood Onset Growth Hormone Insufficiency |
author |
Gonçalves, Jean-Pierre |
author_facet |
Gonçalves, Jean-Pierre Correia, Filipa Cardoso, Helena Borges, Teresa Oliveira, Maria João |
author_role |
author |
author2 |
Correia, Filipa Cardoso, Helena Borges, Teresa Oliveira, Maria João |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Gonçalves, Jean-Pierre Correia, Filipa Cardoso, Helena Borges, Teresa Oliveira, Maria João |
description |
Introduction: The incidence of short stature associated with growth hormone deficiency has been estimated to be about 1:4000 to 1:10000. It is the main indication for treatment with recombinant growth hormone.Objectives: The aims of the study were to evaluate the results of growth hormone stimulation tests and identify the growth hormone deficiency predictors.Material and Methods: A cross-sectional, analytical and observational study was conducted. We studied all the children and adolescents submitted to growth hormone pharmacological stimulation tests between January 2008 and May 2012. Growth hormone deficiency diagnosis was confirmed by two negatives growth hormone stimulation tests (growth hormone peak < 7 ng/ml). The statistical analysis was performed using student t-test, chi-square, Pearson correlation and logistic regression. Statistical significance determined at the 5% level (p ≤ 0.05).Results: Pharmacological stimulation tests were performed in 89 patients, with a median age of 10 [3-17] years. Clonidine (n = 85) and insulin tolerance test (n = 4) were the first growth hormone stimulation tests performed. Growth hormone deficiency was confirmed in 22 cases. In cases with two growth hormone stimulation tests, the growth hormone peak showed a moderate correlation (r = 0.593, p = 0.01). In logistic regression model height (z-score) and the growth hormone peak in first stimulation test were predictors of growth hormone deficiency diagnosis (each one unit increase in z-score decrease the growth hormone deficiency probability).Discussion: Measurement of IGF-1 cannot be used in diagnosing growth hormone deficiency.Conclusion: Auxological criteria associated with a positive test seems to be a reliable diagnostic tool for growth hormone deficiency.Keywords: Growth Disorders; Human Growth Hormone/blood. |
publishDate |
2014 |
dc.date.none.fl_str_mv |
2014-09-25 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
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publishedVersion |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4878 oai:ojs.www.actamedicaportuguesa.com:article/4878 |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4878 |
identifier_str_mv |
oai:ojs.www.actamedicaportuguesa.com:article/4878 |
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por eng |
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por eng |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4878 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4878/4059 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4878/4183 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4878/7299 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4878/7300 |
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openAccess |
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Ordem dos Médicos |
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Ordem dos Médicos |
dc.source.none.fl_str_mv |
Acta Médica Portuguesa; Vol. 27 No. 5 (2014): September-October; 587-592 Acta Médica Portuguesa; Vol. 27 N.º 5 (2014): Setembro-Outubro; 587-592 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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