ArticleWorld journal of experimental medicine2026
Evaluation of growth hormone provocative tests in Egyptian children with growth hormone-related short stature.
Article in World journal of experimental medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDiagnosing growth hormone deficiency (GHD) in children remains challenging because of the considerable variability in the results of growth hormone (GH) provocative tests.
aimTo evaluate the validity of different GH provocative tests, determine the sampling time associated with the peak GH response, and identify optimal GH cut-off values for excluding GHD.
methodsThis cohort study included 50 children aged 5-16 years presenting with proportionate short stature. GH secretion was stimulated using the insulin tolerance test, clonidine test, and levodopa (L-DOPA) test. Serum GH and insulin-like growth factor-1 levels were measured using commercially available enzyme-linked immunosorbent assay kits.
resultsAmong the studied participants, 48% were diagnosed with GHD, while 52% were classified as having idiopathic short stature. The clonidine stimulation test showed the highest median GH level at 90 minutes, followed by the insulin-induced peak at 45 minutes and the L-DOPA peak at 60 minutes. A statistically significant positive correlation was observed between the insulin-like growth factor-1 Z-score and the GH level measured at 90 minutes during the clonidine test. Receiver operating characteristic curve analysis demonstrated optimal GH cut-off values of 7.54 ng/mL for the insulin test, 8.48 ng/mL for the clonidine test, and 4.63 ng/mL for the L-DOPA test. These cut-offs showed sensitivities of 59.3%, 77.8%, and 80%, and specificities of 91.3%, 82.6%, and 70%, respectively.
conclusionOral clonidine and L-DOPA stimulation tests appear to be useful and safe alternatives for diagnosing GHD, avoiding the risk of hypoglycemia associated with the insulin tolerance test. Lower GH peak cut-off values may improve the diagnostic performance of these provocative tests.
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