Camanni F
Division of Endocrinology and Metabolic Diseases, Department of Internal Medicine, University of Turin, Italy.
J Endocrinol Invest. 2006 Feb;29(2):190-4. doi: 10.1007/BF03344096.
The diagnosis of GH deficiency (GHD) in adults is established by laboratory testing in patients with an appropriate clinical history of hypothalamic pituitary disease. As the measurement of IGF-I and IGFBP-3 levels as well as the spontaneous GH secretion are not considered reliable parameters, the diagnosis of GHD in adults may be established by GH provocative tests, provided that a reproducible test with clear normative limits is available. The insulin tolerance test (ITT) is a reliable diagnostic test in adults, but is contraindicated in several clinical conditions which are often observed in adult patients with suspected GHD. The other classic GH provocative tests, except the glucagon test, have a poor diagnostic utility and should be abandoned. GHRH combined with arginine or GH secretagogues represent a potent, safe, reproducible and reliable test which should be preferable to the ITT as a first-choice diagnostic test for GHD.
成人生长激素缺乏症（GHD）的诊断是通过对有适当下丘脑垂体疾病临床病史的患者进行实验室检测来确立的。由于胰岛素样生长因子-I（IGF-I）和胰岛素样生长因子结合蛋白-3（IGFBP-3）水平的测定以及生长激素的自发分泌被认为不是可靠的参数，只要有可重复且有明确正常范围的检测方法，成人GHD的诊断可通过生长激素激发试验来确立。胰岛素耐量试验（ITT）在成人中是一种可靠的诊断试验，但在成年疑似GHD患者中常见的几种临床情况下是禁忌的。除了胰高血糖素试验外，其他经典的生长激素激发试验诊断效用较差，应予以摒弃。生长激素释放激素（GHRH）联合精氨酸或生长激素促分泌素是一种有效、安全、可重复且可靠的试验，作为GHD的首选诊断试验，应优于ITT。
