Departments of Medicine - Endocrinology.
Eur J Endocrinol. 2013 Sep 14;169(4):497-502. doi: 10.1530/EJE-13-0436. Print 2013 Oct.
To determine the diagnostic value of a ghrelin test in the diagnosis of GH deficiency (GHD) shortly after aneurysmal subarachnoid hemorrhage (SAH).
Prospective single-center observational cohort study.
A ghrelin test was assessed after the acute phase of SAH and a GH-releasing hormone (GHRH)-arginine test 6 months post SAH. Primary outcome was the diagnostic value of a ghrelin test compared with the GHRH-arginine test in the diagnosis of GHD. The secondary outcome was to assess the safety of the ghrelin test, including patients' comfort, adverse events, and idiosyncratic reactions.
Forty-three survivors of SAH were included (15 males, 35%, mean age 56. 6 ± 11.7). Six out of 43 (14%) SAH survivors were diagnosed with GHD by GHRH-arginine test. In GHD subjects, median GH peak during ghrelin test was significantly lower than that of non-GHD subjects (5.4 vs 16.6, P=0.002). Receiver operating characteristics analysis showed an area under the curve of 0.869. A cutoff limit of a GH peak of 15 μg/l corresponded with a sensitivity of 100% and a false-positive rate of 40%. No adverse events or idiosyncratic reactions were observed in subjects undergoing a ghrelin test, except for one subject who reported flushing shortly after ghrelin infusion.
Owing to its convenience, validity, and safety, the ghrelin test might be a valuable GH provocative test, especially in the early phase of SAH.
确定在蛛网膜下腔出血（SAH）后急性期进行ghrelin 试验在诊断生长激素缺乏（GHD）中的诊断价值。
前瞻性单中心观察性队列研究。
在 SAH 急性期后评估 ghrelin 试验，6 个月后评估生长激素释放激素（GHRH）-精氨酸试验。主要结局是 ghrelin 试验与 GHRH-arginine 试验在诊断 GHD 中的诊断价值比较。次要结局是评估 ghrelin 试验的安全性，包括患者的舒适度、不良事件和个体反应。
共纳入 43 例 SAH 幸存者（男性 15 例，35%，平均年龄 56.6±11.7）。6 例 SAH 幸存者（14%）通过 GHRH-arginine 试验诊断为 GHD。在 GHD 患者中，ghrelin 试验时 GH 峰值明显低于非 GHD 患者（5.4 对 16.6，P=0.002）。受试者工作特征分析显示曲线下面积为 0.869。GH 峰值为 15μg/l 的截断值的敏感性为 100%，假阳性率为 40%。接受 ghrelin 试验的受试者均未观察到不良事件或个体反应，除 1 例受试者在 ghrelin 输注后出现潮红外。
ghrelin 试验由于其方便、有效和安全，可能是一种有价值的 GH 激发试验，尤其是在 SAH 的早期阶段。
