Abstract
Background and Aims.Existence and diagnostic procedures of neurosecretory dysfunction of growth hormone (NSD) are still a matter of debate. The aim of our study was (a) to find out if prediagnostic auxological and laboratory data could serve as an indicator for pathologic and normal spontaneous GH-secretion and (b) to evaluate the response to GH-therapy in NSD-patients.Methods.Of 90 children (unicentric study) with normal response to GH-stimulation tests, in whom 12-hour night profiles for GH-secretion were performed, 49 were diagnosed with NSD (NSD group). Their auxologic data, IGF-I/IGFBP3-levels as well as the night profiles, were analysed and compared to those of the non-NSD group. Additionally, follow-up auxological data of the GH-treated NSD-patients were collected.Results.Prediagnostic auxologic and laboratory data did not differ between the two groups. Instead, for all analysed criteria of spontaneous GH-secretion (number of peaks, maximal and mean secretion) a significant difference was found. Children with NSD showed a good response to GH-treatment after 1 (ΔH-SDS +0,77 ± 0,48) as well as 4 years (+1,51 ± 0,75).Conclusion.According to our results, analysing spontaneous GH-secretion remains the only method to identify NSD. Yet, as response to GH-treatment is comparable to results in idiopathic GHD, it is worth to consider this diagnosis.
Highlights
Short stature is one of the most frequent reasons for consultation in pediatric endocrine units
For neurosecretory dysfunction of growth hormone (NSD)- as well as non-NSD patients no significant correlations between the findings in the night profiles and any of the analysed prediagnostic parameters H-SDS, height velocity (HV), height velocity-SDS (HV-SDS), weight, IGF-I-SDS, IGFBP3-SDS, and delay in bone age (dBA) were seen (Table 3)
For our whole group of NSD-patients we found a mean gain of H-SDS of 0,77 ± 0,48, HV almost doubled (8,24 ± 1,58 cm/year versus 4,32 ± 1,68 cm/year at baseline) and HV-SDS increased by 4,40 ± 3,5
Summary
Short stature is one of the most frequent reasons for consultation in pediatric endocrine units. We were interested if the diagnostic process could be simplified, if certain prediagnostic data (before measuring spontaneous GH-secretion) used are predictive and if the characteristics used for analysis of this testing are good enough to distinguish between children with and without NSD. The aim of our study was (a) to find out if prediagnostic auxological and laboratory data could serve as an indicator for pathologic and normal spontaneous GH-secretion and (b) to evaluate the response to GH-therapy in NSD-patients. Of 90 children (unicentric study) with normal response to GH-stimulation tests, in whom 12-hour night profiles for GHsecretion were performed, 49 were diagnosed with NSD (NSD group) Their auxologic data, IGF-I/IGFBP3-levels as well as the night profiles, were analysed and compared to those of the non-NSD group. As response to GH-treatment is comparable to results in idiopathic GHD, it is worth to consider this diagnosis
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