Abstract
15N-T and IGF 1-GT were studied by correlating shortterm effects to subsequent growth velocity (GV) during therapy. Methods: Nitrogen excretion Using the stable isotope 15N and IGF 1 were measured before and after 2 IU rHGH/m2 BW s.c. on 3 consecutive days in patients with complete growth hormone deficiency (cGHD, n=17). partial GHD (pGHD, n=16) and normal variant short stature (NVSS, n = 18). Only cGHD and pGHD patients were treated for 1 year with rHGH (12 IU/m2xwk). Before treatment there were no significant differences in auxological data between the 3 groups; 15N-T, IGF 1-GT and growth velocity (GV) were compared with GV in the subsequent year either with rHGH-therapy (cGHD and pGHD) or without (NVSS). 15N-excretion was measured by isotope masspectrometry. IGF 1 was determined by a RIA after extraction. Results: The effect of rHGH-administration on the 15N-T differed significantly between the 3 groups. The best response (143±6.9% 15N-retentlon) was seen in the cGHD group, while 130.1±16,4% (P<0.001) in the pGHD and 108.9±6,4% (p<0,001)ln the NVSS group were reached. The IGF 1-GT did not show any differences between the three groups of patients. After 1 year of rHGH therapy GV was 11,3±3 cm/a in the cGHD and 7.6±2,2 cm/a in the pHGH group. The GV in the untreated NVSS patients was significantly lower (4,2±1,7 cm/a) compared to the cGHD (p<0,001) and the pGHD (p<0.001) patients. The 15N-T can discriminate between patients with complete and partial GHD and patients with short stature after only 3 injections of rHGH. A correlation between 15N-T and GV after 1 year of rHGH treatment was seen in the pGHD group (r=0,87). IGF 1-GT as well GV before treatment were not suitable to predict growth hormone response in any group. Conclusions: In this study the 15N-T was reliable in differentiating the 3 groups of patients and in predicting the response to growth hormone treatment in patients with pGHD.
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