GROWTH HORMONE LEVELS AT INDUCED HYPOGLYCEMIA; AN EFFECTIVE WAY OF DIAGNOSING GROWTH HORMONE DEFICIENCY

Abstract

Objective: To introduce a relatively convenient and effective way of conducting Insulin Tolerance Test for diagnosis of Growth Hormone deficiency in children with short stature.

Study Design: Cross sectional analytical study.

Place and Duration of Study: Conducted at Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology, Rawalpindi, from May 2017 to Jul 2018.

Methodology: A total of 185 cases were included. Sample selection was done by non-probability consecutive sampling technique. Insulin tolerance test was performed by taking basal sample for serum growth hormone and plasma glucose levels before giving intravenous insulin bolus according to dose of 0.15 IU/kg. Samples for Growth Hormone level were repeated at time of induced hypoglycemia (defined as plasma glucose level of <2.8 mmol/L), 30 minutes and 60 minutes post induction.

Results: Mean age of the patients was 10 ± 4 years, majority 120 (65%) were males. In the study population, 41 (22%) patients showed adequate response to insulin tolerance test while 144 (78%) showed inadequate response. At level of induction, mean growth hormone levels were 31.9 ± 18.8 mIU/l and 4.7 ± 4.4 mIU/l in patients showing adequate and inadequate response respectively (p-value <0.05). Majority 32 (78%) of the patients showing adequate response had peak growth hormone response (>20 mIU/l) at induction alone, followed by 30 minutes post induction; reflecting the significance of these two samples in diagnosis of growth hormone deficiency.

Conclusion: We concluded that there is a simpler ...........