Diagnostic Value For Growth Hormone Deficiency In Children And Influencing Factors By Growth Hormone Combined Provocative Test

Objective:To investigate the sensitivity and specificity of the different Growth hormone stimulation tests(GHSTs)in children with short stature,and the influence factors on peak growth hormone(GH)response.To optimize the selection of GHD clinical diagnostic methods and interpret correctly of the excitation test results.Methods:1.76 cases of short stature children(including 46 male,30 female)were collected retrospectively.To compare the sensitivity and specificity of the diagnosis of GHD between combined stimulation test with L-dopa + PD and combined stimulation test with L-dopa + ARG;2.Groups were divided by the peak GH to compare the difference;3.Groups were divided by the diagnosis to compare the difference;4.Groups were divided by the BMI level or puberty to compare the peak level of GH response;5.The influence factors of peak GH during the growth hormone stimulation test were e-valuated by univariate correlation analysis.Results:1.Combined stimulation test with L-dopa + PD detection rate(65/76)was higher than the combined stimulation test with L-dopa + ARG detection rate(64/76),the difference was statistically significant(P<0.05).2.Groups by combined stimulation test with L-dopa + PD:The BMI of CGHD group was higher than the other two groups,the peak GH of L-dopa + ARG,T4,FT3 were lower than the other two groups,T3,FT4 were lower than the PGHD group,PGHD group the peak GH of L-dopa + ARG was lower than the NGHD group,the difference was statistically significant(P<0.05).Groups by combined stimulation test with L-dopa + ARG:CGHD group peak of L-dopa +PD was lower than the other two groups,BMI was higher than the NGHD group,LH was lower than the NGHD group,T3,T4,FT3,FT4 were lower than the PGHD group,the PGHD group peak of L-dopa + PD was lower than the NGHD group,FT3 was higher than the NGHD group,the difference was statistically significant(P<0.05).3.Groups by the diagnosis:CGHD group BMI was higher than the NGHD group,peak of L-dopa + PD and L-dopa + ARG,T4,FT3 were lower than the other two groups,T3 was lower than the PGHD group,PGHD group peak of L-dopa + PD and L-dopa + ARG were lower than the NGHD group,the difference was statistically significant(P<0.05).4.Groups by BMI:obesity + CGHD group BMI was higher than normal + CGHD group,FT4 was lower than normal + CGHD group,obesity + PGHD group BMI was higher than normal + PGHD group,the difference was statistically significant(P<0.05).Groups by puberty:puberty + CGHD group peak of L-dopa + PD was lower than prepuberty + CGHD group,puberty + PGHD group peak of L-dopa + ARG was higher than prepuberty + PGHD group,the difference was statistically significant(P<0.05).5.The univariate correlation analysis showed that peak GH was negatively correlated with BMI.Peak GH of L-dopa + PD was positive correlated with T4,FT3,LH.Peak GH of L-dopa + ARG was positive correlated with FT4,FSH,LH(P<0.05).Conclusion:1.Combined stimulation test with L-dopa + PD is not inferior to combined stimulation test with L-dopa + ARG.The stimulation test using PD combined with L-dopa took orally and didn’t need intravenous drip,so they were recommend to use in an outpatient setting.2.High BMI for short stature children may affect the reaction to drug stimulation tests and diagnosing GHD should be combined with other results.3.To focus on LH and thyroid hormone levels while diagnosing GHD.