Sex steroid priming for growth hormone stimulation testing in children and adolescents with short stature: A systematic review
Authors' conclusion
Sex-steroid priming increases the growth hormone response during GHST, resulting in fewer patients meeting the threshold required for a diagnosis of GHD. Unnecessary GH treatment may be avoided in some patients without a detrimental effect on final height. Numerous sex-steroid priming regimens have been used in clinical practice and the majority appear to be effective, but an optimal regimen has not been determined.
Study context
- Population
- Peripubertal children and adolescents with short stature undergoing growth hormone stimulation testing (GHST) for growth hormone deficiency (GHD); studies including GHST in both primed and unprimed children; GH cut-off 7 µg/L for GHD15 studies
- Comparison
- Sex steroid-primed vs unprimed GHST
- Outcome
- GH response upon GHST
Methodological detailsPROSPERO-registered, PRISMA guidelines, 15 studies included, of which 4/15 (27%) RCTs, Quality assessed with ROBINS-I or revised Cochrane risk-of-bias tool
- PROSPERO-registered
- PRISMA guidelines
- 15 studies included, of which 4/15 (27%) RCTs
- Quality assessed with ROBINS-I or revised Cochrane risk-of-bias tool
Pooled result
As reported in the abstract
Studies indicating priming increases GH response upon GHST, increasing test specificity
9 of 15
Further pooled results
Final height after GH treatment based on primed vs unprimed GHST
- Studies investigating final height
- 2
- GH treatment based on primed GHST improved outcomes vs treatment based on unprimed test
Original publication
Sex steroid priming for growth hormone stimulation testing in children and adolescents with short stature: A systematic review. Clin Endocrinol (Oxf). Published 22 December 2022. doi:10.
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