Urinary growth hormone excretion as a screening test for growth hormone deficiency

Article Abstract:

The secretion of somatotropin, or growth hormone, from the anterior portion of the pituitary occurs in pulses, and is greatest during the slow wave phase of sleep. Tests that screen for deficiency of this growth-regulating hormone are based on its overnight secretion. In addition, the secretion of growth hormone during the day can be provoked or activated by certain drugs. The measurement of blood levels of growth hormone requires the insertion of a catheter and is time-consuming, expensive, unpleasant, and potentially dangerous. Alternatively, growth hormone secretion can be assessed by measuring levels of the hormone in the urine. The overnight secretion of growth hormone was assessed using an immunological technique known as an immunoradiometric assay in 41 children. The children were divided by age into three groups: 3 to 5 years, 6 to 7 years, and 9 to 10 years. The standard urine levels of growth hormone ranged between 2.25 and 10.50 micro-units per night. Children with growth hormone deficiency who were not being treated with growth hormone had levels of the hormone that were level below this range of values. Among 49 children who were being assessed for short stature, those with growth hormone deficiency also had low overnight urinary growth hormone levels. Overnight urinary growth hormone levels were correlated with the maximum response to factors that can activate the secretion of growth hormone. Hence, this urine test may serve as a useful screening method for growth hormone deficiency. (Consumer Summary produced by Reliance Medical Information, Inc.)

Testing, Medical screening, Health screening, Somatotropin, Urine, Urinalysis, Dwarfism, Pituitary, Pituitary dwarfism

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The reliability of height measurement: (The Wessex Growth Study)

Article Abstract:

The reliability of a method of evaluation can be assessed by determining the accuracy and reproducibility of results. Accuracy refers to the closeness of observations to the target or actual value. Reproducibility or precision reflects the degree of variability in measurements. The reliability of measuring height in children was assessed in three studies. In the first study, a meter rod or ruler was used to check the accuracy of installation of 230 measuring instruments. The measurements ranged from 90.0 to 108.5 centimeters (cm), indicating the need to routinely check the positioning of measuring instruments. The reproducibility of height measurements was assessed in the second and third studies. In the second study, the heights of 10 children, ranging in height from 106.0 to 152.0 cm, were measured by two different and experienced observers three times using five different instruments of varying design. The measurements were made under blind and random conditions. The standard deviation, which refers to the differences in measurements, is a measure of error and ranged from 0.2 to 0.3 cm. Variation was related to the child rather than the measuring instrument or observer. The third study was similar to the second study, except that measurements were not blind or random, which closely approximates the clinical setting. The estimate of error was lower but false in the third study. These findings indicate that error should be stated in all published studies of growth. (Consumer Summary produced by Reliance Medical Information, Inc.)

Experimental design, Research design

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Are measurements of height made by health visitors sufficiently accurate for routine screening of growth?

Article Abstract:

The accuracy of height measurements made by public health examiners for use in routine screening of children was assessed. Specifically, the reliability between different observers (interobserver), and of a single observer taking several measurements (intraobserver), were evaluated. The heights of 10 children aged three years and 10 others aged four and a half years were measured by two groups of four health visitors. Height was measured using two different techniques, and values were compared with those obtained by a trained auxologist, or person experienced in taking growth measurements, using a measuring device called a Harpenden stadiometer. Both measuring devices gave reasonably accurate single measurements of height. The height of one three-year-old was 100 centimeters (cm), as measured by a wall chart, and true height could be expected to lie between 99.2 cm and 101.8 cm. The height of a four-and-a-half-year-old was 110 cm, with the true value lying between 108.9 and 111.9 cm. The most narrow range of values for growth rate between the ages of three and four and a half years could be determined using the Microtoise measuring device, taking the average of three measurements. The findings show that the measurements made by health visitors are accurate enough for routine screening of height. Appropriate training may help to improve the calculation of the rate of height increase. (Consumer Summary produced by Reliance Medical Information, Inc.)

Children, Growth

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