Glucagon Stimulation Testing in Adult Growth Hormone Deficiency— A 2014 Update

2014 ◽  
Vol 10 (01) ◽  
pp. 75
Author(s):  
Kevin C J Yuen ◽  
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
The Elderly ◽  
Tolerance Test ◽  
Clinical Findings ◽  
Clinical Syndrome ◽  
Stimulation Test ◽  
Hormone Deficiency ◽  
Insulin Tolerance ◽  
Adult Growth

Growth hormone deficiency (GHD) is a well-recognized clinical syndrome in adults, and its diagnosis is established through one or more GH stimulation tests. The decision to perform GH stimulation testing should be based on medical history and clinical findings, and using appropriate GH stimulation test/s for biochemical confirmation. The insulin tolerance test (ITT) remains the diagnostic test of choice; however, this test is labor intensive, contraindicated in the elderly and in adults with seizure disorders and ischemic heart disease, can be unpleasant for the patient, and is potentially hazardous. With the discontinuation of the growth hormone releasing hormone (GHRH) analog (Geref®) in the US in 2008, the glucagon stimulation test (GST) has gained increasing popularity as the alternative test to the ITT because of its availability, reproducibility, safety, lack of influence by gender and hypothalamic cause of GH deficiency (GHD), and relatively few contraindications. In this article, recommendations for performing this test, the potential drawbacks in conducting and caveats in interpreting this test, and its future perspectives are discussed.

Glucagon Testing in Adult Growth Hormone Deficiency— Current Status and Future Perspectives

2011 ◽  
Vol 07 (01) ◽  
pp. 51
Author(s):  
Kevin C J Yuen ◽  
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
The Elderly ◽  
Tolerance Test ◽  
Clinical Syndrome ◽  
Stimulation Test ◽  
Hormone Deficiency ◽  
Current Status ◽  
Future Perspectives ◽  
Adult Growth

Growth hormone deficiency (GHD) in adults is a recognized clinical syndrome and its diagnosis is established through GH stimulation testing. The decision to perform GH stimulation testing should be based on clinical findings, medical history and using the appropriate GH stimulation test to obtain biochemical evidence. The insulin tolerance test (ITT) remains the diagnostic test of choice, but this test is labor intensive, contraindicated in the elderly and in adults with seizure disorders and ischemic heart disease, can be unpleasant for the patient, and is potentially hazardous. The glucagon stimulation test (GST) in recent years has been increasingly used as the alternative test to the ITT in the US and Europe because of its availability, reproducibility, safety, lack of influence by gender and hypothalamic cause of GHD, and relatively few contraindications. In the article, we discuss our recommendations in performing this test, the potential drawbacks in conducting and caveats in interpreting this test, and its future perspectives.

scholarly journals Glucagon Testing in Adult Growth Hormone Deficiency – Current Status and Future Perspectives

2010 ◽  
Vol 7 (2) ◽  
pp. 104
Author(s):  
Kevin C J Yuen ◽  
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
The Elderly ◽  
Tolerance Test ◽  
Clinical Syndrome ◽  
Stimulation Test ◽  
Hormone Deficiency ◽  
Current Status ◽  
Future Perspectives ◽  
Adult Growth

Growth hormone deficiency (GHD) in adults is a recognised clinical syndrome and its diagnosis is established through GH stimulation testing. The decision to perform GH stimulation testing should be based on clinical findings, medical history and using the appropriate GH stimulation test to obtain biochemical evidence. The insulin tolerance test (ITT) remains the diagnostic test of choice, but this test is labour intensive, contraindicated in the elderly and in adults with seizure disorders and ischaemic heart disease, can be unpleasant for the patient, and is potentially hazardous. The glucagon stimulation test (GST) in recent years has been increasingly used as the alternative test to the ITT in the US and Europe because of its availability, reproducibility, safety, lack of influence by gender and hypothalamic cause of GHD, and relatively few contraindications. In the article, we discuss our recommendations in performing this test, the potential drawbacks in conducting and caveats in interpreting this test, and its future perspectives.

scholarly journals Glucagon Stimulation Testing in Assessing for Adult Growth Hormone Deficiency: Current Status and Future Perspectives

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Kevin C. J. Yuen
Keyword(s):  
United States ◽  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
The United States ◽  
Clinical Syndrome ◽  
Hormone Deficiency ◽  
Current Status ◽  
Future Perspectives ◽  
Adult Growth ◽  
Igf I

Growth hormone deficiency (GHD) is a well-recognized clinical syndrome in adults. However, due to the high frequency of normal serum IGF-I levels in hypopituitary adults with GHD, it is now widely accepted that despite normal levels of total IGF-I, adults clinically suspected with GHD within the appropriate clinical setting must undergo GH provocative testing to confirm its diagnosis. Although the insulin tolerance test (ITT) is labor intensive, contraindicated in the elderly and in adults with seizure disorders and ischemic heart disease, can be unpleasant for the patient, and is potentially hazardous, this test remains the gold standard test for the biochemical demonstration of GHD in adults. In contrast, with the unavailability of the GHRH and arginine test as the alternative test to the ITT in the United States since 2008, the glucagon stimulation test (GST) has since been increasingly used in the United States because of its availability, reproducibility, safety, lack of influence by gender and hypothalamic cause of GHD, and relatively few contraindications. In this paper, we discuss our recommendations in performing this test, the potential drawbacks in conducting and caveats in interpreting this test, and its future perspectives.

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