Determinants Of The Growth Hormone Nadir During Oral Glucose Tolerance Test In Adults

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  • Katharina Schilbach, Klinikum der Universität München
  • ,
  • Christina Gar, Klinikum der Universität München
  • ,
  • Andreas Lechner, Klinikum der Universität München
  • ,
  • Shiva Sophia Nicolay, Klinikum der Universität München
  • ,
  • Laura Schwerdt, Klinikum der Universität München
  • ,
  • Michael Haenelt, Klinikum der Universität München
  • ,
  • Jakob Dal
  • Jens Otto L Jorgensen
  • Sylvere Störmann, Klinikum der Universität München
  • ,
  • Jochen Schopohl, Klinikum der Universität München
  • ,
  • Martin Bidlingmaier, Klinikum der Universität München

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 cut-offs to biological variables utilizing todays assay methods are scarce. We therefore investigated large cohorts of healthy subjects of both sexes to define normal GHnadir concentrations for a modern, sensitive, 22kD-GH specific assay.

DESIGN: Multicenter study with prospective and retrospective cohorts (525 healthy adults; 405 females, 120 males).

METHODS: GH concentrations were measured by the IDS-iSYS immunoassay after oral application of 75g glucose.

RESULTS: GHnadir concentrations (µg/L) were significantly higher in lean and normal 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 impact 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 cut-offs used in previous guidelines for diagnosis and monitoring of acromegaly.

TidsskriftEuropean Journal of Endocrinology
Sider (fra-til)55-67
Antal sider13
StatusUdgivet - 2019

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