Growth Hormone Stimulation Testing in Childhood: Diagnostic Pathways and Discordant Results in a Tertiary Centre Cohort
Authors' conclusion
Approximately one in four children with a subthreshold first GHST was not ultimately diagnosed with GHD. These findings support the need for repeat testing before initiating treatment in children without independent evidence of pituitary disease.
Study context
- Population
- Children who underwent GHST for suspected growth hormone deficiency (GHD) at a tertiary Irish paediatric endocrinology centrechildren who underwent GHST for suspected GHD
- Participants
- 73 children
- Index test or model
- IGF-I, IGFBP-3 and the IGF-I/IGFBP-3 molar ratio against a final diagnosis of GHD
- Target condition
- GHD
Performance
As reported in the abstract
| Test or model | Sensitivity | Specificity |
|---|---|---|
| IGF-I | 45.5% | 50.0% |
| IGFBP-3 | 9.1% | 100% |
Sensitivity
IGF-I45.5%
IGFBP-39.1%
Specificity
IGF-I50.0%
IGFBP-3100%
Further findings
Final diagnosis
- GHD diagnosed
- 34 children (47%)
- GHD excluded
- 39 (53%)
GHD subsequently excluded among children with a first peak GH below 7 µg/L
- Children with a first peak GH below 7 µg/L
- 47
- GHD subsequently excluded, of the 47
- 13
- Apparent false-positive rate, among the 47
- 27.7% (95% CI 16.9-41.8)
- Severely subthreshold initial response (peak GH < 3 µg/L), of the 13 with GHD excluded
- Six
- Discordant results were clustered in peripubertal children
Original publication
Growth Hormone Stimulation Testing in Childhood: Diagnostic Pathways and Discordant Results in a Tertiary Centre Cohort. Clin Endocrinol (Oxf). Published 10 November 2026. doi:10.
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