Gelato M C, Malozowski S, Caruso-Nicoletti M, Ross J L, Pescovitz O H, Rose S, Loriaux D L, Cassorla F, Merriam G R
J Clin Endocrinol Metab. 1986 Jul;63(1):174-9. doi: 10.1210/jcem-63-1-174.
The normal ranges for GH responses to GH-releasing hormone (GHRH) have previously been defined for adult men and women. To determine whether the GHRH responses of normal children differ from those of adults and whether children with GH deficiency (GHD) and children who are growing below the first percentile but are otherwise normal (ISS) have GH responses comparable to those of normal children, we studied 90 normal children, 46 girls and 44 boys, with heights between the 10th and 95th percentiles for age, at different pubertal stages. Their responses were compared to those of 24 children with ISS and 32 children with GHD and to values previously measured in young adult men and women. Girls were grouped by Tanner breast stages and boys by testicular volumes. Plasma somatomedin-C, estradiol or testosterone, and bone age were measured in all children. All received a 1 microgram/kg iv bolus dose of GHRH-(1-44)NH2, and GH responses were measured during a 2-h sampling period. Incremental serum GH responses in girls did not change throughout pubertal development and were similar to those of adult women. The responses in boys at midpuberty were somewhat lower (P less than 0.05) than those in either prepubertal boys or adult men. ISS children had mean GH responses [23 +/- 4 (+/- SE) ng/ml] similar to those of normal children. GHD children had significantly lower mean GH responses (11 +/- 3.7 ng/ml) than normal prepubertal children (35 +/- 4.0 ng/ml; P less than 0.01), but the responses of 17 of the 32 GHD children overlapped with the normal range. GH responses to GHRH were not correlated with bone age, weight, height, SmC levels, or estradiol or testosterone concentrations. These results indicate that GH responses to GHRH testing are relatively constant throughout puberty and young adulthood, that ISS children respond normally to GHRH, and that the GHRH test is not a reliable discriminator between individual normal and GHD children.
生长激素（GH）对生长激素释放激素（GHRH）反应的正常范围先前已针对成年男性和女性确定。为了确定正常儿童对GHRH的反应是否与成年人不同，以及生长激素缺乏症（GHD）儿童和身高低于第一百分位数但其他方面正常的儿童（特发性身材矮小，ISS）的GH反应是否与正常儿童相当，我们研究了90名正常儿童，46名女孩和44名男孩，年龄处于第10至95百分位数之间，处于不同的青春期阶段。将他们的反应与24名ISS儿童和32名GHD儿童的反应以及先前在年轻成年男性和女性中测量的值进行比较。女孩按坦纳乳房分期分组，男孩按睾丸体积分组。测量了所有儿童的血浆生长调节素-C、雌二醇或睾酮以及骨龄。所有人均接受了1微克/千克静脉推注剂量的GHRH-(1-44)NH2，并在2小时的采样期内测量了GH反应。女孩的血清GH反应增量在整个青春期发育过程中没有变化，并且与成年女性相似。青春期中期男孩的反应比青春期前男孩或成年男性的反应略低（P<0.05）。ISS儿童的平均GH反应[23±4（±标准误）纳克/毫升]与正常儿童相似。GHD儿童的平均GH反应（11±3.7纳克/毫升）明显低于正常青春期前儿童（35±4.0纳克/毫升；P<0.01），但32名GHD儿童中有17名的反应与正常范围重叠。GH对GHRH的反应与骨龄、体重、身高、SmC水平或雌二醇或睾酮浓度无关。这些结果表明，在整个青春期和年轻成年期，GH对GHRH测试的反应相对恒定，ISS儿童对GHRH反应正常，并且GHRH测试不是区分个体正常儿童和GHD儿童的可靠方法。
