Sex hormone priming prior to the combined hypoglycaemia test.

Abstract

The insulin hypoglycaemia test (IHT) was performed on 3 groups of short stature children. One group was unprimed with sex steroid hormones, a second group received 17 beta-oestradiol, while a third group received testosterone. The dosage of insulin was adjusted to produce a nadir in blood glucose of reversible 1 mmol/L. When this level is achieved plasma growth hormone (GH) responses less than 10 mU/L are not improved by either priming procedure. It is suggested from the data that there is no place for a diagnosis of a partial GH deficiency state. When the IHT is combined with Gn-RH and TRH infusion the data derived may indicate GH-RH deficiency alone or additionally a CRF deficiency. Alternatively a pituitary insensitivity to these releasing substances or a pituitary synthetic failure of all trophic hormones may be adduced. Unless a releasing hormone is deficient and the pituitary is shown to be able to respond to its synthetic analogue, treatment with the available analogues will fail to give the desired clinical response.