Real-world diagnostic performance of the macimorelin stimulation test in the diagnosis of adult growth hormone deficiency
Performance · Met AGHD criteriaResult — go to the resultAbsolute diagnostic yield difference 13.5 % 95% CI 2.5%–24.5%Authors' conclusion
Applying the 5.1 ng/mL cut-off classified more AGHD cases than 2.8 ng/mL, with discordant classifications concentrated among patients with higher BMI in low pre-test probability group, suggesting obesity may contribute to diagnostic reclassification. Diagnostic classification was unchanged when the 90-minute sample was omitted in our cohort.
Study context
- Population
- Adults undergoing macimorelin stimulation testing for adult GHD, categorized into high, intermediate and low pre-test probability
- Participants
- 37 adults
- Comparison
- GH cut-off 5.1 ng/mL vs 2.8 ng/mL in macimorelin stimulation test
- Outcome
- Diagnostic classification (adult GH deficiency (AGHD)) at the 2.8 and 5.1 ng/mL cut-offs; absolute diagnostic yield difference
Methodological detailssingle-centre
- Single-centre
Performance
Met AGHD criteria
Absolute diagnostic yield difference
13.5 %
95% CI 2.5%–24.5%
two-sided exact McNemar p = 0.0625
Events by group
5.1 ng/mLvs 2.8 ng/mL
absolute diagnostic yield difference 13.5 % (95% CI 2.5%–24.5%); two-sided exact McNemar p = 0.0625
As reported in the abstract
- Discordant patients: 1 high, 1 intermediate, 3 low pre-test probability (all three body mass index (BMI) > 35 kg/m²)
- 5
Further findings
| Outcome | Discordant | Concordant | Mean difference (kg/m²) (95% CI) | |
|---|---|---|---|---|
| BMI, discordantvs concordant, low pre-test probability | 37.7 ± 2.7 kg/m² | 28.2 ± 4.6 kg/m² | 9.5 (5–14) | |
| −1001020Difference, kg/m² (linear scale) |
BMI vs peak GH, low pre-test probability
- Spearman ρ (p = 0.006)
- - 0.67
GH at 60 vs 90 min
- Correlation r (p < 0.0001)
- 0.775
- Excluding the 90-minute sample did not alter diagnostic outcomes
Original publication
Real-world diagnostic performance of the macimorelin stimulation test in the diagnosis of adult growth hormone deficiency. Pituitary. Published 7 March 2026. doi:10.
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