Rosenfeld R G
Department of Pediatrics, Oregon Health Sciences University, Portland 97201, USA.
Horm Res. 1996;46(4-5):170-3. doi: 10.1159/000185018.
The cornerstones in the evaluation of short stature are auxology and biochemical testing. Traditionally, the diagnosis of growth hormone (GH) deficiency has been based upon measurement of serum concentrations of GH following either physiological or pharmacological stimulation, or determination of spontaneous GH secretory patterns. Assessment of pituitary GH secretion is, however, fraught with problems, including the nonphysiological nature of provocative testing, the reliance on arbitrary definitions of subnormal responses, the inadequate attention paid to age- and puberty-related variability, and the dependence upon assays with marginal concordancy. It is proposed that the evaluation of short stature is best pursued by careful auxology plus assessment of the insulin-like growth factor (IGF) axis, with particular attention to measurements of serum concentrations of IGF-I and IGF-binding protein-3. The diagnosis of IGF deficiency can then be readily established, and its etiology pursued logically.
评估身材矮小的基石是体格检查和生化检测。传统上，生长激素（GH）缺乏症的诊断基于生理或药物刺激后血清GH浓度的测量，或自发GH分泌模式的测定。然而，垂体GH分泌的评估存在诸多问题，包括激发试验的非生理性、对异常反应的任意定义的依赖、对年龄和青春期相关变异性的关注不足以及对一致性较差的检测方法的依赖。有人提出，身材矮小的评估最好通过仔细的体格检查加上胰岛素样生长因子（IGF）轴的评估来进行，尤其要关注血清IGF-I和IGF结合蛋白-3浓度的测量。然后可以很容易地确立IGF缺乏症的诊断，并合理地追查其病因。
