Association of Sex Steroid Priming on Growth Hormone Stimulation
Growth hormone deficiency is most important cause to evaluate for the assessment of short stature although growth hormone deficiency is not common but the most important case to rule out. Assessment of short stature begins with detailed and careful history and comprehensive detailed physical medical examination including any dysmorphic features, anthropometric measurements like body mass index (BMI), Weight, height, weight for age, height for age, body proportion, midparental height, and pubertal staging. After detailed examination need to rule out other common causes of short stature like hypothyroidism, anemia, and renal disorder and this is followed by initial screening of Insulin like growth factor (IGF-1) and reduced height velocity. Traditionally growth hormone deficiency diagnosis is established by growth hormone response less than cutoff limits of two or more provocative test. Various growth hormone stimulation test is used for this purpose like exercise stimulation test, Levodopa stimulation test, clonidine stimulation test, arginine stimulation test and gold standard used for this purpose is insulin tolerance test which has some side effects like it can cause hypoglycemia, coma and it is contraindicated in patient with heart disease and epilepsy that why it is replaced by glucagon stimulation test.
Methodology: This study was a cross-sectional study conducted after the Institutional Review Board (IRB) approval at AFIP from January 2018 to June 2018. Data was collected from 149 children of 9-13 year of age reported to endocrinology clinic AFIP, after informed consent. Inclusion criteria included healthy adults with age of 9-13 years with no minor or subclinical illness or endocrinology disorders like hypothyroid, Cushing syndrome or Addison disease. Patients with comorbidity like cancer, tuberculosis and bed ridden patients were excluded from study. Sampling technique was non probability convenience sampling which was done in endocrine clinic of AFIP.
Results: A total of 149 patients were inducted in study who visited Endocrine clinic in AFIP. Mean age of participants was 9.9 ± 3.9 year while 96 (64.4%) were male and 52 (34.9%) were female. Total of 149 patients there were 100 (67.1%) patients were below 3rd percentile, while 44 (29.5%) were above 3rd percentile but below 50th percentile and 4 (2.7%) were at 50th percentile. Independent T test was applied for Priming and response level after growth hormone stimulation test and it gives significant level (P value=0.00) which is considered significant (P value <0.05).
Conclusion: This study concluded that priming after sex steroids can effect on growth hormone level in pre pubertal children’s and it will help in appropriate diagnosis of growth hormone deficiency.
Author-Ain QU, Noreen, et al.
Biochemistry & Analytical Biochemistry
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