Peak Growth Hormone Response to Combined Stimulation Test in 315 Children and Correlations with Metabolic Parameters

Mabel Yau, Elizabeth Chacko, Molly O. Regelmann, Rachel Annunziato, Elizabeth J. Wallach, Dennis J. Chia, Robert Rapaport

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Background/Aims: Studies are lacking regarding the timing of peak growth hormone (PGH) response. We aim to elucidate the timing of PGH response to arginine and levodopa (A-LD) and evaluate the influence of body mass index (BMI) and other metabolic parameters on PGH. Methods: During growth hormone (GH) stimulation testing (ST) with A-LD, serum GH was measured at baseline and every 30 min up to 180 min. The PGH cut-off was defined as <10 ng/mL. IGF-1, IGF BP3, BMI, and metabolic parameters were obtained in a fasting state at baseline. Results: In the 315 tested children, stimulated PGH levels occurred at or before 120 min in 97.8% and at 180 min in 2.2%. GH area under the curve (AUC) positively correlated with PGH in all patients and with IGF-1 in pubertal males and females. BMI negatively correlated with PGH in all subjects. GH AUC negatively correlated with HOMA-IR and total cholesterol. Conclusion: We propose termination of the GH ST with A-LD at 120 min since omission of GH measurement at 180 min did not alter the diagnosis of GH deficiency based on a cut-off of < 10 ng/mL. BMI should be considered in the interpretation of GH ST with A-LD. The relationships between GH AUC and metabolic parameters need further study.

Original languageEnglish (US)
Pages (from-to)36-44
Number of pages9
JournalHormone Research in Paediatrics
Issue number1
StatePublished - Dec 1 2019


  • Growth hormone deficiency
  • Growth hormone provocative test
  • Insulin resistance
  • Short stature

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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