Palayew K, Crock P, Pianosi P, Coates A, Weitzner G, Schiffrin A
Division of Endocrinology and Metabolism, Montreal Children's Hospital, Quebec.
Clin Invest Med. 1991 Aug;14(4):331-7.
Growth hormone (GH) response to standardized exercise, L-DOPA/propranolol and a 6-h diurnal GH profile (GHP) were evaluated in twenty-three children with very short stature and abnormal growth velocities. Standardized exercise (Jones Stage I) was performed on a cycle ergometer at 53% of the maximum oxygen consumption (VO2max) for 20 min. VO2max was determined by an incremental progressive workload until exhaustion. The mean +/- SEM peak GH concentration (ng/ml) for each test was: exercise, 8.7 +/- 1.3; L-DOPA/P: 12.8 +/- 1.9 and GHP: 3 +/- 0.7. There was no statistical difference between exercise and L-DOPA/P peaks but both peaks were significantly higher than the peak observed during the profile. During exercise 14 of 23 patients had a GH response greater than 8 ng/ml. Two patients were found to be GH deficient. Therefore 16 of 23 patients (86%) had a result concordant with their final diagnosis. During the L-DOPA/P test 17 of 23 patients had a GH response greater than 8 ng/ml. By contrast only 6 of 23 patients had a positive response during GHP. Standardized exercise is as effective as L-DOPA/P as a stimulation test for growth hormone response in very short children with abnormal growth velocities. Exercise has the advantages of being physiological, having minimal side effects, and requiring fewer blood samples. In this population of children, exercise and L-DOPA/propranolol are significantly better than the 6-h growth hormone profile for assessing GH secretion.
对23名身材极矮且生长速度异常的儿童，评估了其生长激素（GH）对标准化运动、左旋多巴/普萘洛尔的反应以及6小时的昼夜生长激素谱（GHP）。在自行车测力计上以最大耗氧量（VO2max）的53%进行标准化运动（琼斯I期），持续20分钟。通过递增负荷运动直至疲劳来测定VO2max。每项测试的平均±标准误峰值GH浓度（ng/ml）分别为：运动，8.7±1.3；左旋多巴/普萘洛尔：12.8±1.9；GHP：3±0.7。运动和左旋多巴/普萘洛尔的峰值之间无统计学差异，但两者的峰值均显著高于生长激素谱期间观察到的峰值。运动期间，23名患者中有14名的GH反应大于8 ng/ml。发现2名患者生长激素缺乏。因此，23名患者中有16名（86%）的结果与其最终诊断一致。在左旋多巴/普萘洛尔测试期间，23名患者中有17名的GH反应大于8 ng/ml。相比之下，23名患者中只有6名在GHP期间有阳性反应。对于生长速度异常的极矮儿童，标准化运动作为生长激素反应的刺激试验与左旋多巴/普萘洛尔一样有效。运动具有生理性、副作用最小且所需血样较少的优点。在这群儿童中，运动和左旋多巴/普萘洛尔在评估GH分泌方面明显优于6小时生长激素谱。
