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- Title
Determinants of the growth hormone nadir during oral glucose tolerance test in adults.
- Authors
Schilbach, Katharina; Gar, Christina; Lechner, Andreas; Nicolay, Shiva Sophia; Schwerdt, Laura; Haenelt, Michael; Dal, Jakob; Jørgensen, Jens-Otto Lunde; Störmann, Sylvère; Schopohl, Jochen; Bidlingmaier, Martin
- Abstract
Objective: Growth hormone (GH) nadir (GHnadir) during oral glucose tolerance test (OGTT) is an important tool in diagnosing acromegaly, but data evaluating the need to adjust c ut-offs to biological variables utilizing today's assay methods are scarce. We therefore investigated large cohorts of healthy subjects of both sexes to define normal GH nadir concentrations for a modern, sensitive, 22 kD-GH-specific assay. Design: Multicenter study with prospective and retrospective cohorts (525 healthy adults: 405 females and 120 males). Methods: GH concentrations were measured by the IDS-iSYS immunoassay af ter oral application of 75 g glucose. Results: GHnadir concentrations (µg/L) were significantly higher in lean and nor mal weight subjects (group A) compared to overweight and obese subjects (group B); (males (M): A vs B, mean: 0.124 vs 0.065, P = 0.0317; premenopausal females without estradiol-containing OC (OC-EE) (FPRE): A vs B, mean: 0.179 vs 0.092, P < 0.0001; postmenopausal women (FPOST): A vs B, mean: 0.173 vs 0.078, P < 0.0061). Age, glucose metabolism and menstrual cycle had no im pact on GHnadir. However, premenopausal females on OC-EE (FPREOC) exhibited significantly higher GHnadir compared to all other groups (all P < 0.0001). BMI had no impact on GHnadir in FPREOC (A vs B, mean: 0.624 vs 0.274, P = 0.1228). Conclusions: BMI, sex and OC-EE intake are the major determinants for the GHnadir during OGTT in healthy adults. Using a modern sensitive GH assay, GHnadir concentrations in healthy subjects are distinctly lower than c ut-offs used in previous guidelines for diagnosis and monitoring of acromegaly.
- Subjects
GLUCOSE tolerance tests; SOMATOTROPIN; ACROMEGALY; ADULTS; MENSTRUAL cycle
- Publication
European Journal of Endocrinology, 2019, Vol 181, Issue 1, p55
- ISSN
0804-4643
- Publication type
Article
- DOI
10.1530/EJE-19-0139