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Patients Diagnosed With Severe Adult GH Deficiency Using The Insulin Tolerance Test, Arginine Or Glucagon Stimulation Tests Share Similar Clinical Features
Department of Endocrinology, University Hospitals Birmingham NHS Foundation Trust, United Kingdom.
Experimental and Clinical Endocrinology, Medizinische Klinik I, Lübeck, Germany.
Department. of Endocrinology, CliniquesUniversitaires Saint-Luc, Brussels.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Barnendokrinologisk forskning/Gustafsson)
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2011 (English)In: Endocrine Practice, ISSN 1530-891X, 1-26 p.Article in journal (Refereed) Published
Abstract [en]


To determine whether the ITT, arginine (AST) and glucagon stimulation tests (GST) identify patients who have similar features of GH deficiency using a diagnostic threshold of 3 μg/l.

Patients and Methods:

5453 tests were available from 4,867 patients registered in the KIMS database (49.9% females, ITT = 3111, AST = 1390, GST = 952). Comparisons were made for GH peak, BMI, lipids, waist circumference, waist:hip ratio and quality of life (QoL-AGHDA questionnaire).


There were significant (p<0.0001) intra-individual correlations between the GH peaks for the ITT vs AST (r = 0.655), ITT vs GST (r = 0.445) and AST vs GST (r = 0.632). GH peaks in response to all tests were negatively correlated to the number of additional pituitary hormone deficiencies, and positively correlated to IGF-I SDS. BMI had a negative influence on all three tests.

Comparing GHD patients according to the diagnostic test used, most clinical variables did not differ between the groups. The only exceptions showing any difference were BMI being slightly higher in the AST and GST groups, triglyceride levels increased in the GST group, and IGF-I SDS was lower in the ITT and AST than in the GST group. Waist circumference was larger and quality of life was worse in the GST group than in the other groups.


This study demonstrates that the ITT, AST and GST produce similar GH peaks, are influenced by similar clinical factors and identify patients with similar features of GH deficiency at a diagnostic threshold of 3 μg/L.

Place, publisher, year, edition, pages
2011. 1-26 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-167417DOI: 10.4158/EP11146.ORISI: 000304234100003PubMedID: 22068248OAI: oai:DiVA.org:uu-167417DiVA: diva2:484666
Available from: 2012-01-27 Created: 2012-01-27 Last updated: 2012-06-18Bibliographically approved

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