Misra Madhusmita, Cord Jennalee, Prabhakaran Rajani, Miller Karen K, Klibanski Anne
Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, Massachusetts 02114, USA.
J Clin Endocrinol Metab. 2007 Dec;92(12):4623-9. doi: 10.1210/jc.2007-1244. Epub 2007 Sep 18.
GH nonsuppression after oral glucose is diagnostic for GH excess, but normative data are lacking in children. Adult data cannot be extrapolated to children given the pubertal increase in GH concentration. In addition, because GH levels are higher in pubertal girls than boys, nadir GH may differ across gender.
Our objective was to determine whether nadir GH during an oral glucose tolerance test (OGTT) is gender and pubertal stage specific. We hypothesized that nadir GH would be higher in girls, and at the pubertal stage known to correspond with peak height velocity (Tanner 2-3 in girls and Tanner 3-4 in boys) and maximal GH concentrations. SUBJECTS/ METHODS: A 2-h OGTT using 2.35 g/kg oral glucose (maximum 100 g) was performed in 64 girls and 43 boys, 9-17 yr (10th-90th percentiles for body mass index). Girls were grouped as group 1 (Tanner 1), group 2 (Tanner 2-3), and group 3 (Tanner 4-5), and boys as group 1 (Tanner 1-2), group 2 (Tanner 3-4), and group 3 (Tanner 5).
Nadir GH was higher in girls than boys, and in group 2 girls and boys than the other two groups. The upper limit for nadir GH was highest in group 2 girls (1.57 ng/ml), and lower for the other two groups of girls (0.64 ng/ml), and for boys (0.50 ng/ml). All but one girl, and all boys suppressed to less than 1.0 ng/ml. There were 16 girls and five boys who had a nadir GH of more than 0.3 ng/ml.
GH suppression after oral glucose is gender and pubertal stage specific.
口服葡萄糖后生长激素（GH）未被抑制可诊断为GH分泌过多，但儿童缺乏相关的标准数据。鉴于青春期GH浓度会升高，成人数据不能外推至儿童。此外，由于青春期女孩的GH水平高于男孩，最低GH水平可能因性别而异。
我们的目的是确定口服葡萄糖耐量试验（OGTT）期间的最低GH水平是否具有性别和青春期阶段特异性。我们假设女孩的最低GH水平会更高，且在已知与身高增长峰值速度相对应的青春期阶段（女孩为坦纳2-3期，男孩为坦纳3-4期）以及GH浓度最高时。
对象/方法：对64名女孩和43名9至17岁（体重指数处于第10至90百分位数）的男孩进行了2小时的OGTT，口服葡萄糖剂量为2.35 g/kg（最大100 g）。女孩分为第1组（坦纳1期）、第2组（坦纳2-3期）和第3组（坦纳4-5期），男孩分为第1组（坦纳1-2期）、第2组（坦纳3-4期）和第3组（坦纳5期）。
女孩的最低GH水平高于男孩，第2组女孩和男孩的最低GH水平高于其他两组。第2组女孩的最低GH水平上限最高（1.57 ng/ml），其他两组女孩（0.64 ng/ml）和男孩（0.50 ng/ml）的上限较低。除一名女孩外，所有女孩和所有男孩的GH水平均被抑制至低于1.0 ng/ml。有16名女孩和5名男孩的最低GH水平超过0.3 ng/ml。
口服葡萄糖后GH的抑制具有性别和青春期阶段特异性。
