Algorithm of short stature diagnosis in patients without disorder of somatotropic function

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Objective — to develop of algorithm for differential diagnostics and prediction of effective treatment in patients with short stature on the background of preserved somatotropic function.Materials and methods. All children had a growth retardation more than ‑2 SD. To study the state of physical development, anthropometric parameters such as height, body weight, body mass index, growth rate, target height, predicted height were evaluated. For the differential diagnosis of biologically inactive growth hormone syndrome (BIGHS) and growth hormone receptor insensitive syndrome (GHRIS), a four‑day growth hormone sensitivity (GHS) test was used. To clarify the sensitivity to GH, a test for the generation of insulin‑like growth factor‑1 (IGF‑1) to GH, which consisted of two steps, was performed. The test for the generation of IGF‑1 for GH was carried out in 55 patients. The age of patients at the beginning of the study ranged from 4 to 14 years.Results. An algorithm for the diagnosis of short stature with reduced IGF‑1 level has been developed. In the case of a positive test, when IGF‑1 is increased by 2 or more times, the BIGH syndrome is confirmed, and treatment with GH drugs are prescribed for such patients. With a weakly positive test, in when IGF‑1 level is increased by less than 2‑fold compared to basal values, it is recommended to test the generation of IGF‑1 to GH to clarify the diagnosis of short stature and determine the adequate dose of GH drugs.Conclusions. The test for the generation of IGF‑1 to GH, which is the basis of the algorithm for differential diagnosis of short stature with preserved somatotropic function, namely BIGH syndrome, GHRI syndrome and idiopathic short stature is highly effective for predicting the treatment of these patients with recombinant GH.