Similar clinical features among patients with severe adult growth hormone deficiency diagnosed with insulin tolerance test or arginine or glucagon stimulation tests

Andrew Toogood; Georg Brabant; Dominique Maiter; Björn Jonsson; Ulla Feldt-Rasmussen; Maria Koltowska-Haggstrom; Åse Krogh Rasmussen; Michael Buchfelder; Bernhard Saller; Beverly M K Biller

doi:10.4158/ep11146.or

Similar clinical features among patients with severe adult growth hormone deficiency diagnosed with insulin tolerance test or arginine or glucagon stimulation tests

Andrew Toogood, Georg Brabant, Dominique Maiter, Björn Jonsson, Ulla Feldt-Rasmussen, Maria Koltowska-Haggstrom, Åse Krogh Rasmussen, Michael Buchfelder, Bernhard Saller, Beverly M K Biller

13 Citations (Scopus)

Abstract

Objective: To determine whether insulin tolerance tests (ITTs), arginine stimulation tests (ASTs), and glucagon stimulation tests (GST) identify patients who have similar clinical features of growth hormone (GH) deficiency when a diagnostic GH threshold of 3 μg/L is used.Methods: Data were obtained from the KIMS database (Pfizer International Metabolic Database). Comparisons were made between patients who underwent ITT, AST, or GST for GH peak, body mass index, lipids, waist circumference, waist-to-hip ratio, and quality of life.Results: A total of 5453 tests were available from 4867 patients registered in the database (ITT = 3111, AST = 1390, GST = 952). Significant (P<.001) intraindividual correlations were observed between the GH peaks for 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 the insulinlike growth factor 1 standard deviation score. Body mass index had a negative influence on all 3 tests. Most clinical variables did not differ between the groups when comparing GH-deficient patients according to the diagnostic test used. The only exceptions that showed any difference were body mass index (slightly higher in the AST and GST groups), triglyceride levels (increased in the GST group), and insulinlike growth factor 1 (standard deviation score) (lower in the ITT and AST groups than in the GST group). Waist circumference was greater and quality of life was worse in the GST group than in the other groups.Conclusions: 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.

Original language	English
Journal	Endocrine Practice
Volume	18
Issue number	3
Pages (from-to)	325-34
Number of pages	10
ISSN	1530-891X
DOIs	https://doi.org/10.4158/ep11146.or
Publication status	Published - 1 May 2012

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Toogood, A., Brabant, G., Maiter, D., Jonsson, B., Feldt-Rasmussen, U., Koltowska-Haggstrom, M., Rasmussen, Å. K., Buchfelder, M., Saller, B., & Biller, B. M. K. (2012). Similar clinical features among patients with severe adult growth hormone deficiency diagnosed with insulin tolerance test or arginine or glucagon stimulation tests. Endocrine Practice, 18(3), 325-34. https://doi.org/10.4158/ep11146.or

In: Endocrine Practice, Vol. 18, No. 3, 01.05.2012, p. 325-34.

Research output: Contribution to journal › Journal article › Research › peer-review

Toogood, A, Brabant, G, Maiter, D, Jonsson, B, Feldt-Rasmussen, U, Koltowska-Haggstrom, M, Rasmussen, ÅK, Buchfelder, M, Saller, B & Biller, BMK 2012, 'Similar clinical features among patients with severe adult growth hormone deficiency diagnosed with insulin tolerance test or arginine or glucagon stimulation tests', Endocrine Practice, vol. 18, no. 3, pp. 325-34. https://doi.org/10.4158/ep11146.or

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title = "Similar clinical features among patients with severe adult growth hormone deficiency diagnosed with insulin tolerance test or arginine or glucagon stimulation tests",

abstract = "Objective: To determine whether insulin tolerance tests (ITTs), arginine stimulation tests (ASTs), and glucagon stimulation tests (GST) identify patients who have similar clinical features of growth hormone (GH) deficiency when a diagnostic GH threshold of 3 μg/L is used.Methods: Data were obtained from the KIMS database (Pfizer International Metabolic Database). Comparisons were made between patients who underwent ITT, AST, or GST for GH peak, body mass index, lipids, waist circumference, waist-to-hip ratio, and quality of life.Results: A total of 5453 tests were available from 4867 patients registered in the database (ITT = 3111, AST = 1390, GST = 952). Significant (P<.001) intraindividual correlations were observed between the GH peaks for 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 the insulinlike growth factor 1 standard deviation score. Body mass index had a negative influence on all 3 tests. Most clinical variables did not differ between the groups when comparing GH-deficient patients according to the diagnostic test used. The only exceptions that showed any difference were body mass index (slightly higher in the AST and GST groups), triglyceride levels (increased in the GST group), and insulinlike growth factor 1 (standard deviation score) (lower in the ITT and AST groups than in the GST group). Waist circumference was greater and quality of life was worse in the GST group than in the other groups.Conclusions: 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.",

author = "Andrew Toogood and Georg Brabant and Dominique Maiter and Bj{\"o}rn Jonsson and Ulla Feldt-Rasmussen and Maria Koltowska-Haggstrom and Rasmussen, {{\AA}se Krogh} and Michael Buchfelder and Bernhard Saller and Biller, {Beverly M K}",

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doi = "10.4158/ep11146.or",

language = "English",

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T1 - Similar clinical features among patients with severe adult growth hormone deficiency diagnosed with insulin tolerance test or arginine or glucagon stimulation tests

AU - Toogood, Andrew

AU - Brabant, Georg

AU - Maiter, Dominique

AU - Jonsson, Björn

AU - Feldt-Rasmussen, Ulla

AU - Koltowska-Haggstrom, Maria

AU - Rasmussen, Åse Krogh

AU - Buchfelder, Michael

AU - Saller, Bernhard

AU - Biller, Beverly M K

PY - 2012/5/1

Y1 - 2012/5/1

N2 - Objective: To determine whether insulin tolerance tests (ITTs), arginine stimulation tests (ASTs), and glucagon stimulation tests (GST) identify patients who have similar clinical features of growth hormone (GH) deficiency when a diagnostic GH threshold of 3 μg/L is used.Methods: Data were obtained from the KIMS database (Pfizer International Metabolic Database). Comparisons were made between patients who underwent ITT, AST, or GST for GH peak, body mass index, lipids, waist circumference, waist-to-hip ratio, and quality of life.Results: A total of 5453 tests were available from 4867 patients registered in the database (ITT = 3111, AST = 1390, GST = 952). Significant (P<.001) intraindividual correlations were observed between the GH peaks for 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 the insulinlike growth factor 1 standard deviation score. Body mass index had a negative influence on all 3 tests. Most clinical variables did not differ between the groups when comparing GH-deficient patients according to the diagnostic test used. The only exceptions that showed any difference were body mass index (slightly higher in the AST and GST groups), triglyceride levels (increased in the GST group), and insulinlike growth factor 1 (standard deviation score) (lower in the ITT and AST groups than in the GST group). Waist circumference was greater and quality of life was worse in the GST group than in the other groups.Conclusions: 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.

AB - Objective: To determine whether insulin tolerance tests (ITTs), arginine stimulation tests (ASTs), and glucagon stimulation tests (GST) identify patients who have similar clinical features of growth hormone (GH) deficiency when a diagnostic GH threshold of 3 μg/L is used.Methods: Data were obtained from the KIMS database (Pfizer International Metabolic Database). Comparisons were made between patients who underwent ITT, AST, or GST for GH peak, body mass index, lipids, waist circumference, waist-to-hip ratio, and quality of life.Results: A total of 5453 tests were available from 4867 patients registered in the database (ITT = 3111, AST = 1390, GST = 952). Significant (P<.001) intraindividual correlations were observed between the GH peaks for 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 the insulinlike growth factor 1 standard deviation score. Body mass index had a negative influence on all 3 tests. Most clinical variables did not differ between the groups when comparing GH-deficient patients according to the diagnostic test used. The only exceptions that showed any difference were body mass index (slightly higher in the AST and GST groups), triglyceride levels (increased in the GST group), and insulinlike growth factor 1 (standard deviation score) (lower in the ITT and AST groups than in the GST group). Waist circumference was greater and quality of life was worse in the GST group than in the other groups.Conclusions: 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.

U2 - 10.4158/ep11146.or

DO - 10.4158/ep11146.or

M3 - Journal article

C2 - 22068248

SN - 1530-891X

VL - 18

SP - 325

EP - 334

JO - Endocrine Practice

JF - Endocrine Practice

IS - 3

ER -

Similar clinical features among patients with severe adult growth hormone deficiency diagnosed with insulin tolerance test or arginine or glucagon stimulation tests

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