Growth Hormone Testing (GH Testing)
Growth hormone (GH) testing is done to measure the level of human growth hormone in the blood. GH is a hormone produced by the pituitary gland in the head. A doctor may order one of the following tests if there are symptoms that indicate abnormal amounts of GH:
There are many factors that can interfere with GH testing. Stress, physical activity, certain medications, and blood glucose levels can all cause changes in GH levels. For this reason, GH tests are often performed in conjunction with measurements of other hormones, such as IGF-1 (insulin-like growth factor-1).
Tests to suppress growth hormone secretion are carried out:
Stimulation tests for GH are carried out:
To prepare for the procedure, most patients need:
The needle insertion site will be cleaned. A rubber band will be placed around the upper arm and a needle will be inserted into the vein. The blood will be collected into a syringe. Once the syringe is filled, the needle will be removed from the skin. The puncture site is pressed.
Blood will be collected between 6 and 8 am. You will be asked to drink a solution of water and glucose (sugar). Glucose should lower the level of GH in the blood. Two more blood samples are taken within one to two hours after consuming the solution. Each blood sample will have GH levels measured. IGF-1 levels can also be measured since they do not change as much as GH levels.
Blood samples will be collected at different time intervals (five samples). The first sample for blood glucose, cortisol and growth hormone will be collected between 6 and 8 am. Insulin is then injected through the IV. Insulin should lower blood glucose levels, which should increase GH levels. Blood samples will be collected at 30, 60, 90 and 120 minutes to repeat glucose, cortisol and growth hormone levels.
If the blood sugar level has not dropped to a certain level, a second dose of insulin is administered after 45 minutes. Blood samples will be collected at 75 and 150 minutes. If your blood sugar drops too low, a glucose drip is used to restore it.
Blood samples will be taken five times at different intervals. The first sample is collected between 6 and 8 am. After 30 minutes, arginine or GH-releasing peptide will be administered through the IV. After this, GH-releasing hormone is injected intravenously, which should stimulate the pituitary gland to produce GH. A further four blood samples are taken every 30 minutes after the infusions.
You can go about your daily activities.
The procedure often takes at least three hours.
There may be minor discomfort as the needle is inserted into the skin and the medications are infused. Your doctor will monitor your insulin tolerance because too much insulin can cause your blood sugar levels to drop.
The doctor will tell you the test results. Further testing or treatment may be needed.
After returning home, you should consult a doctor if the following symptoms appear:
Growth retardation is a widespread problem in pediatric endocrinology. This condition is heterogeneous in nature and can be caused by various etiopathogenetic factors. One of the reasons causing delay growth disorder secretion of somatotropic hormone (GH). GH deficiency in the absence of treatment leads to a pronounced delay physical development. Timely diagnosis this pathology and adequately carried out replacement therapy growth hormone preparations allows patients to achieve socially acceptable indicators of physical development.
Currently, methods for diagnosing GH deficiency are well developed. A study of the basal level of growth hormone is not very informative, because During the day there are significant fluctuations in the hormone in the blood. Only initially high level STH (>10 ng/ml), allows without additional examination exclude insufficiency of its secretion. A low basal level of a hormone is not evidence of deficiency. In this regard, in order to study the secretory function of somatotrophs in clinical practice various provocative tests aimed at stimulating GH secretion pharmacological drugs. To reliably assess the somatotropic function of the pituitary gland, it is recommended to conduct at least 2 stimulation tests. The most common tests are tests using clonidine and insulin.
The above tests are widely used to diagnose somatotropic insufficiency when examining children with growth retardation on the basis of the children's endocrinology department of the Central Clinical Hospital of the Ministry of Railways. Determination of the level of growth hormone is carried out in the department of radioisotope diagnostics of the Central Clinical Hospital of the Ministry of Railways using the radioimmunochemical method using diagnostic kits from the company “IMMUNOTECH” (Czech Republic). All stimulation tests are carried out on an empty stomach, while lying down, at 8-9 am.
Insulin test. An increase in GH secretion in response to hypoglycemia occurs through activation of the α 2 - adrenergic system, which leads to suppression of somatostatin tone. The insulin test is carried out according to the following method: An insulin solution (0.05 IU/kg for children under 4 years of age and 0.1 IU/kg for children over 4 years of age) is injected intravenously at point 0. Blood is drawn from the injected v .cubitalis catheter, the patency of which is maintained by slow infusion isotonic solution, at -15, 0, 15, 30, 45. 60, 90, 120 min to determine glucose and growth hormone levels. The greatest drop in glucose levels is observed at 15-30 minutes. The maximum level of growth hormone is determined, as a rule, at 60 minutes. Hypoglycemia is an activating stimulus for the secretion of ACTH and cortisol, which makes it possible to examine their levels during the test and diagnose secondary hypocortisolism. The test results can be considered reliable if the glucose level decreases to at least 2.2 mmol/l or by 50% compared to baseline. The most serious side effect This stimulation test is due to severe hypoglycemia; therefore, when performing the test, it is necessary to have a 40% glucose solution and a sweet drink.
Test with clonidine. The main mechanism of the stimulating effect of clonidine on GH secretion is the activation of GH-releasing hormone. Clonidine is administered per os at a dose of 0.15 mg/m 2 body surface at point 0. Blood is drawn at -15, 0, 130, 60, 90, 120, 150 minutes. The maximum increase in GH concentration is observed between 90 and 120 minutes. Clonidine leads to the development arterial hypotension and severe drowsiness, therefore, blood pressure monitoring should be carried out during the test and for 3 hours after its completion. In case of a significant decrease in blood pressure, after the test is administered standard solution caffeine in an age-appropriate dosage.
Evaluation of the results of stimulation tests. An increase in growth hormone levels >10 ng/ml (in both samples) indicates normal level secretion of growth hormone. Stimulated GH level<7 нг/мл позволяет установить диагноз соматотропной недостаточности. Уровень гормона роста в пределах 7-10 нг/мл свидетельствует о частичном дефиците СТГ.
Thus, stimulation tests (with clonidine and insulin) are a reliable and accessible method for diagnosing GH deficiency.
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On an empty stomach (at least 8 and no more than 14 hours of fasting). You can drink water without gas. It is recommended to take blood in the morning from 8.00 to 12.00, unless another time is indicated by the attending physician. On the eve of the study, it is necessary to exclude sports training, stress and food overload. Immediately before taking blood, the patient should be at rest for at least 10 to 15 minutes.
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Research method: IHLA
STH is a hormone of the anterior pituitary gland. The main function of growth hormone is to stimulate the growth and development of the body. HGH activates protein synthesis, linear growth, lipolysis in adipose tissue, and activates glycogenolysis. Increased secretion of GH during growth leads to gigantism, and in adults - to acromegaly; decreased secretion leads to dwarfism.
A single measurement of GH in the blood is not very informative, since GH secretion has a pulsed nature due to the influence of stress on its level, physical activity, which may lead to false results.
Reference values (standard version):
| Age, years | Men | Women | Units of measurement |
|---|---|---|---|
| from 0 to 7 days | 1,18 - 27,0 | 2,4 -24,0 | ng/ml |
| from 7 to 15 days | 0,69 - 17,3 | 1,07-17,6 | |
| from 30 days to 4 years | 0,43 - 2,40 | 0,5 - 3,5 | |
| from 4 to 7 years | 0,09 - 2,50 | 0,1 - 2,2 | |
| from 7 to 9 years | 0,15 - 3,20 | 0,16 - 5,4 | |
| from 9 to 11 years | 0,09 - 1,95 | 0,08 - 3,1 | |
| 11 years old | 0,08 - 4,70 | 0,12 - 6,9 | |
| 12 years old | 0,12 - 8,90 | 0,14 - 11,2 | |
| 13 years old | 0,10 - 7,90 | 0,21 - 17,8 | |
| 14 years old | 0,09 - 7,10 | 0,14 - 9,9 | |
| 15 years | 0,10 - 7,80 | 0,24 - 10,0 | |
| 16 years old | 0,08 - 11,40 | 0,26 - 11,7 | |
| 17 years old | 0,22 - 12,20 | 0,3 - 10,8 | |
| from 18 to 20 years | 0,97 - 4,70 | 0,24 - 4,3 | |
| from 20 years and older | 0.06 - 5.00 | 0.06 - 5.00 |
We draw your attention to the fact that the interpretation of research results, establishment of a diagnosis, as well as the prescription of treatment, in accordance with Federal law Federal Law No. 323 “On the fundamentals of protecting the health of citizens in Russian Federation", must be performed by a doctor of appropriate specialization.
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All processes in our body are regulated by a whole complex produced by several organs. All of them are of great importance for the formation, development and functioning of the body. One of these important substances is growth hormone. It sets external physical parameters human body, shapes his height and proportions.
This hormone is one of many that control the functioning of our body. Hormonal system is vital for human well-being, so a malfunction in one of the hormone-producing organs leads to the whole system going out of tune.
The cause of disturbances in the process of GH production may be hereditary pathology, problems with intrauterine development, nutritional disorders of the mother, her abuse of alcohol, narcotic and psychotropic drugs and smoking during gestation, taking certain medicines, negative impact poor environmental conditions, poor quality water, radiation exposure and many other factors. Most often, they all act in a complex manner, leading to the development of pathologies.
Somatotropic growth hormone is produced in the anterior lobe of the pituitary gland. Its main function is to influence the structure and development of the body. This substance affects the growth of the body, which is why we grow. The born child is very small, but by the end of puberty, under the influence of hormones produced in his body, he reaches the growth inherent in him by nature. This indicator depends on many factors: heredity, health, nutrition and other reasons, so we all have different dimensions.
But growth hormone is the main force causing growth in the body in general, so any significant deviations in its production lead to serious problems with health and appearance.
If a sharp decrease in the production of growth hormone is observed in the human body during puberty, then this condition leads to the development of dwarfism, or pituitary dwarfism. Increased output growth hormone during puberty leads to gigantism, that is, excessively high growth. If the growth process and active production of growth hormone continues into adulthood, excessive growth of bones throughout the body occurs, which leads to the development of a special disease called.
A growth hormone test is prescribed if the child has of a certain age slow or accelerated growth is noted, deformation of the bone skeleton with elongation of the limbs, and in an adult with closing growth zones on the bones, their shape changes, facial features become coarser, and sexual underdevelopment occurs.
At general examination analysis is not performed, since it is only necessary if there is clinical disorders or suspected dysfunction. It makes no sense to do an analysis “just in case”, since the hormone is released cyclically, in waves, so the result will never be the same, and therefore accurate.
To obtain accurate indicators, a sampling technique is used to suppress and stimulate it.
In this case, doctors have the opportunity to accurately evaluate the data and obtain information that deserves complete confidence. To carry out further treatment this is especially important since the future dosage of hormones depends on this information. It must be accurate to avoid further “skew” in hormonal background body.
An analysis for growth hormone is performed when studying the function, if its excess or deficiency is suspected, after obtaining data on other hormones of the human body.
Before taking a sample, you must properly prepare for the procedure. To do this, it is recommended to do the following:
| Norms for growth hormone levels, in mIU/l | ||
| Person's age | Male gender | Female gender |
| From birth | 3,0-70,2 | 6,2- 62,4 |
| up to 3 years | 1,1-6,2 | 1,3- 9,1 |
| 4-6 years | 0,23-6,5 | 0,26-5,7 |
| 7-8 years | 0,4-8,3 | 0,4-14,0 |
| 9-10 years | 0,23-5,1 | 0,2-8,1 |
| 11 years old | 0,2-12,2 | 0,3-17,9 |
| 12 years old | 0,3-23,1 | 0,36-29,1 |
| 13 years old | 0,26-20,5 | 0,55-46,3 |
| 14 years old | 0,23-18,5 | 0,36-25,7 |
| 15 years | 0,26-20,3 | 0,62-26 |
| 16 years old | 0,2-29,6 | 0,68-30,4 |
| 17 years old | 0,57-31,7 | 0,8-28,1 |
| 18-19 years old | 2,5-12,2 | 0,62-11,2 |
| > 19 years old | 0,16-13,0 | 0,16-13,0 |
