Short stature with normal growth hormone stimulation testing: lack of evidence for partial growth hormone deficiency or insensitivity.

Objectives: To test the hypothesis that children with short stature and peak stimulated GH (pGH) of 7 - 10 mug/l have partial GH deficiency and to test the hypothesis that short children with normal pGH but low IGF-I levels have partial GH deficiency or partial GH insensitivity. Design and Patients: Retrospective analysis of the clinical and biochemical profiles of 76 children who underwent an evaluation for short stature ( height <5th percentile) that included two, sex steroid-primed GH stimulation tests. Results: Patients with pGH <7 mug/l ( n = 14) differed significantly from those with pGH <7 mu g/l ( n = 62), having greater midparental height (MPH) SDS, a greater disparity between height SDS and MPH SDS, and lower IGF-I SDS. Patients with pGH of 7 - 10 mu g/l ( n = 12) did not have characteristics intermediate between those with pGH <7 mug/l and those with pGH greater than or equal to10 mug/l, but instead resembled those with pGH greater than or equal to10 mug/l. Patients with pGH greater than or equal to7 mug/l, but low IGF-I (< - 2 SDS) ( n = 5), did not show characteristics intermediate between those with pGH <7 mug/l and those with pGH greater than or equal to7 mug/l and normal IGF-I. Conclusions: These data do not support either the hypothesis that children with pGH of 7 - 10 mug/l have partial GH deficiency or the hypothesis that children with normal pGH but subnormal IGF-I levels have partial GH deficiency or insensitivity. Copyright (C) 2004 S. Karger AG, Basel.