Urinary growth hormone level and insulin-like growth factor-1 standard deviation score (IGF-SDS) can discriminate adult patients with severe growth hormone deficiency

Toshio Hirohata; Nobuhito Saito; Koji Takano; So Yamada; Jae-Hyun Son; Shoko M. Yamada; Hiroshi Nakaguchi; Katsumi Hoya; Mineko Murakami; Akiko Mizutani; Hiroko Okinaga; Akira Matsuno

doi:10.1507/endocrj.EJ12-0196

ORIGINALS

Urinary growth hormone level and insulin-like growth factor-1 standard deviation score (IGF-SDS) can discriminate adult patients with severe growth hormone deficiency

Toshio Hirohata, Nobuhito Saito, Koji Takano, So Yamada, Jae-Hyun Son, Shoko M. Yamada, Hiroshi Nakaguchi, Katsumi Hoya, Mineko Murakami, Akiko Mizutani, Hiroko Okinaga, Akira Matsuno

Author information

Toshio Hirohata
Department of Neurosurgery, Teikyo University Chiba Medical Center, Ichihara 299-0111, Japan
Department of Neurosurgery, The University of Tokyo, Tokyo 113-8655, Japan
Nobuhito Saito
Department of Neurosurgery, The University of Tokyo, Tokyo 113-8655, Japan
Koji Takano
Department of Nephrology & Endocrinology, The University of Tokyo, Tokyo 113-8655, Japan
So Yamada
Department of Neurosurgery, Teikyo University Chiba Medical Center, Ichihara 299-0111, Japan
Jae-Hyun Son
Department of Neurosurgery, Teikyo University Chiba Medical Center, Ichihara 299-0111, Japan
Shoko M. Yamada
Department of Neurosurgery, Teikyo University Chiba Medical Center, Ichihara 299-0111, Japan
Hiroshi Nakaguchi
Department of Neurosurgery, Teikyo University Chiba Medical Center, Ichihara 299-0111, Japan
Katsumi Hoya
Department of Neurosurgery, Teikyo University Chiba Medical Center, Ichihara 299-0111, Japan
Mineko Murakami
Department of Neurosurgery, Teikyo University Chiba Medical Center, Ichihara 299-0111, Japan
Akiko Mizutani
Teikyo Heisei University, Tokyo 170-8445, Japan
Hiroko Okinaga
Teikyo Heisei University, Tokyo 170-8445, Japan
Akira Matsuno
Department of Neurosurgery, Teikyo University Chiba Medical Center, Ichihara 299-0111, Japan

Keywords: Adult growth hormone deficiency, Hypothalamic-pituitary disease, Insulin-like growth factor-1, Urinary growth hormone

JOURNAL FREE ACCESS

2013 Volume 60 Issue 3 Pages 369-373

DOI https://doi.org/10.1507/endocrj.EJ12-0196

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Abstract

Adult growth hormone (GH) deficiency (AGHD) in Japan is diagnosed based on peak GH concentrations during GH provocative tests such as GHRP-2 stimulation test. In this study, we aimed to evaluate the ability of serum insulin-like growth factor-1 (sIGF-1) and urinary GH (uGH) at the time of awakening to diagnose AGHD. Fifty-nine patients with pituitary disease (32 men and 27 women; age 20-85 y (57.5 ± 15.5, mean ± SD) underwent GHRP-2 stimulation and sIGF-1 testing. Thirty-six and 23 patients were diagnosed with and without severe AGHD, respectively based on a peak GH response of <9 ng/mL to GHRP-2 stimulation. Serum IGF-1 was evaluated as a standard deviation score (IGF-1 SDS) based on age and sex. We determined whether uGH levels in urine samples from 42 of the 59 patients at awakening were above or below the sensitivity limit. We evaluated IGF-1 SDS and uGH levels in a control group of 15 healthy volunteers. Values for IGF-1 SDS were significantly lower in patients with, than without (-2.07 ± 1.77 vs.-0.03 ± 0.92, mean ± SD; p < 0.001) AGHD whereas the range of IGF-1 SDS substantially overlapped at >-1.4. IGF-1 SDS discriminated AGHD more effectively in patients aged ≤60 years. The χ² test revealed a statistical relationship between uGH and AGHD (test statistic: 7.0104 ≥ χ² (1; 0.01) = 6.6349). When IGF-1 SDS is <-1.4 or uGH is below the sensitivity limit, AGHD can be detected with high sensitivity.

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