ArticleThe Journal of clinical endocrinology and metabolism2024
Accuracy of Glucagon Testing Across Transition in Young Adults With Childhood-Onset GH Deficiency.
Article in The Journal of clinical endocrinology and metabolism, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Growth hormone retesting for idiopathic isolated growth hormone deficiency during and after puberty: a systematic review.Journal of the Endocrine Society · 2026Review
- Endocrine late-effects in survivors of childhood and adolescence cancer: clinical management.Journal of endocrinological investigation · 2026Review
- GH Response to Glucagon in Transition: Role of Body Mass Index and Etiology in Childhood-onset GH Deficiency.The Journal of clinical endocrinology and metabolism · 2026Article
- A Growth Prediction Model from Mid-Puberty to Near Adult Height in Adolescents with Idiopathic Isolated Growth Hormone Deficiency Treated with Growth Hormone.Hormone research in paediatrics · 2025Article
- The diagnosis of GH deficiency in adult β-thalassemic patients: are two different stimulation tests necessary to improve specificity?Pituitary · 2025Article
- Consensus and controversies about diagnosing GH deficiency: a Delphi survey by the GH research society.Pituitary · 2025Review
- Predictive Factors of Persistent Growth Hormone Deficiency and Impact on Final Height.Children (Basel, Switzerland) · 2025Article
- A 2024 Update on Growth Hormone Deficiency Syndrome in Adults: From Guidelines to Real Life.Journal of clinical medicine · 2024Review
- Policy for transitioning childhood-onset growth hormone deficiency from pediatric to adult endocrine care in Belgium.Frontiers in endocrinology · 2024Review
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Authors and funding
18 authors.
Funding
Abstract
contextThe 2019 American Association of Clinical Endocrinologists guidelines suggested peak GH-cutoffs to glucagon test (GST) of ≤3 and ≤1 µg/L in the diagnosis of permanent GH deficiency (GHD) during the transition phase.
objectiveThe aim of the study was to evaluate the accuracy of GST compared to insulin tolerance test (ITT) in the definition of GHD at adult height achievement. PATIENTS AND
methodsNinety-seven subjects with childhood-onset GHD (median age, 17.39 years) underwent ITT, GST, and IGF-1 testing; 44 subjects were idiopathic (isolated GHD), 35 moderate organic GHD (0-2 hormone deficiencies) and 18 severe organic GHD (≥3 hormone deficiencies).
resultsBland and Altman analysis showed a high consistency of GH peak measures after ITT and GST. Receiver operating characteristic analysis identified 7.3 μg/L as the optimal GH peak cutoff to GST [95% confidence interval (CI) 4.15-8.91; sensitivity 95.7%, specificity 88.2%, positive predictive value (PPV) 88.0%, negative predictive value (NPV) 95.7%] able to correctly classify 91.8% of the entire cohort while 5.8 μg/L was the best GH peak cutoff able to correctly classify 91.4% of moderate organic GHD patients (95% CI 3.16-7.39; sensitivity 96.0%, specificity 80.0%, PPV 92.3%, NPV 88.9%). Patients with ≥3 hormone deficiencies showed a GH peak <5 μg/L at ITT and <5.8 μg/L at GST but 1. The optimal cutoff for IGF-1 was -1.4 SD score (95% CI -1.94 to 0.77; sensitivity 75%, specificity 94%, PPV 91.7%, NPV 81.0%) that correctly classified 85.1% of the study population.
conclusionA GH peak to GST <5.8 μg/L represents an accurate diagnostic cutoff for young adults with childhood-onset GHD and high pretest probability of permanent GHD.
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