Performance of different growth hormone immunoassays in the diagnosis of growth hormone deficiency.

ROPELATO MG; DOMENÉ HM; MARTINEZ A; ESCOBAR ME; PENNISI P; JASPER HG; HEINRICH JJ

Iguazu

Congreso; X Reunión de la Sociedad Latinoamericana de Endocrinologìa Pediátrica (SLEP).; 1996

SLEP

APLICACION DE DIFERENTES INMUNOENSA YOS DE HORMONA DE CRECIMIENTO (GH) EN EL DIAGNOSTICO DE LA INSUFICIENCIA DE GH MG Ropelato, HM Domené, A Martínez, ME Escobar, P Pennisi, H Jasper, JJ Heinrich. División de Endocrinología. CEDIE. Hospital de Nii´íos Dr. R Gutiérrez. Buenos Aires. Argentina. La determinación de honnona de crecimiento presenta gran variabilidad usando distintm inmunoensayos (IE) con diferente sensibilidad y especificidad. Objetivo: a) valorar el nivel máximo dé GH (GH ma.x) en respuesta a estímulos farmacológicos utilizando tres diferentes rE y b) comparar s1.: capacidad discririllnatoria en el diagnóstico de la insuficiencia de GH. Se estudiaron 29 niños con baj<: estatura, 22 sin signos clínicos de deficiencia de GH (SS) Y 7 deficientes (GHD). Se realizó pruebé secuencial de arginina-donidina en dos ocasiones, previo tratamiento con estradiol (E2 1-2 mg,oral). e placebo durante 3 días. Se detenninó GH max en 58 muestras por RlA (desarrollado, dosis minimé detectable, ´D,MD: 1.0 ugIL), lRMA (Serono, MAlA, DlVID: 0.15 ugIL) e JB..1A (DELFIA, DMD O.OlugIL).Resultados: La correlación entre los tres métodos fue altamente significativa: IRMA vs RlA r=0.97, IFMA ´,´sRIA, r=O.93 e IFMA vs IRMA, r=0.97, p<O.OOJ). El nivel medio GH max (X±DS)) el intervalo de confianza del 95% en los niños con SS fueron: bajo placebo 11.1 ± lOA (3.1-40.5), 10.-1 secuencial de arginina-donidina en dos ocasiones, previo tratamiento con estradiol (E2 1-2 mg,oral). e placebo durante 3 días. Se detenninó GH max en 58 muestras por RlA (desarrollado, dosis minimé detectable, ´D,MD: 1.0 ugIL), lRMA (Serono, MAlA, DlVID: 0.15 ugIL) e JB..1A (DELFIA, DMD O.OlugIL).Resultados: La correlación entre los tres métodos fue altamente significativa: IRMA vs RlA r=0.97, IFMA ´,´sRIA, r=O.93 e IFMA vs IRMA, r=0.97, p<O.OOJ). El nivel medio GH max (X±DS)) el intervalo de confianza del 95% en los niños con SS fueron: bajo placebo 11.1 ± lOA (3.1-40.5), 10.-1 capacidad discririllnatoria en el diagnóstico de la insuficiencia de GH. Se estudiaron 29 niños con baj<: estatura, 22 sin signos clínicos de deficiencia de GH (SS) Y 7 deficientes (GHD). Se realizó pruebé secuencial de arginina-donidina en dos ocasiones, previo tratamiento con estradiol (E2 1-2 mg,oral). e placebo durante 3 días. Se detenninó GH max en 58 muestras por RlA (desarrollado, dosis minimé detectable, ´D,MD: 1.0 ugIL), lRMA (Serono, MAlA, DlVID: 0.15 ugIL) e JB..1A (DELFIA, DMD O.OlugIL).Resultados: La correlación entre los tres métodos fue altamente significativa: IRMA vs RlA r=0.97, IFMA ´,´sRIA, r=O.93 e IFMA vs IRMA, r=0.97, p<O.OOJ). El nivel medio GH max (X±DS)) el intervalo de confianza del 95% en los niños con SS fueron: bajo placebo 11.1 ± lOA (3.1-40.5), 10.-1 secuencial de arginina-donidina en dos ocasiones, previo tratamiento con estradiol (E2 1-2 mg,oral). e placebo durante 3 días. Se detenninó GH max en 58 muestras por RlA (desarrollado, dosis minimé detectable, ´D,MD: 1.0 ugIL), lRMA (Serono, MAlA, DlVID: 0.15 ugIL) e JB..1A (DELFIA, DMD O.OlugIL).Resultados: La correlación entre los tres métodos fue altamente significativa: IRMA vs RlA r=0.97, IFMA ´,´sRIA, r=O.93 e IFMA vs IRMA, r=0.97, p<O.OOJ). El nivel medio GH max (X±DS)) el intervalo de confianza del 95% en los niños con SS fueron: bajo placebo 11.1 ± lOA (3.1-40.5), 10.-1 rE y b) comparar s1.: capacidad discririllnatoria en el diagnóstico de la insuficiencia de GH. Se estudiaron 29 niños con baj<: estatura, 22 sin signos clínicos de deficiencia de GH (SS) Y 7 deficientes (GHD). Se realizó pruebé secuencial de arginina-donidina en dos ocasiones, previo tratamiento con estradiol (E2 1-2 mg,oral). e placebo durante 3 días. Se detenninó GH max en 58 muestras por RlA (desarrollado, dosis minimé detectable, ´D,MD: 1.0 ugIL), lRMA (Serono, MAlA, DlVID: 0.15 ugIL) e JB..1A (DELFIA, DMD O.OlugIL).Resultados: La correlación entre los tres métodos fue altamente significativa: IRMA vs RlA r=0.97, IFMA ´,´sRIA, r=O.93 e IFMA vs IRMA, r=0.97, p<O.OOJ). El nivel medio GH max (X±DS)) el intervalo de confianza del 95% en los niños con SS fueron: bajo placebo 11.1 ± lOA (3.1-40.5), 10.-1 secuencial de arginina-donidina en dos ocasiones, previo tratamiento con estradiol (E2 1-2 mg,oral). e placebo durante 3 días. Se detenninó GH max en 58 muestras por RlA (desarrollado, dosis minimé detectable, ´D,MD: 1.0 ugIL), lRMA (Serono, MAlA, DlVID: 0.15 ugIL) e JB..1A (DELFIA, DMD O.OlugIL).Resultados: La correlación entre los tres métodos fue altamente significativa: IRMA vs RlA r=0.97, IFMA ´,´sRIA, r=O.93 e IFMA vs IRMA, r=0.97, p<O.OOJ). El nivel medio GH max (X±DS)) el intervalo de confianza del 95% en los niños con SS fueron: bajo placebo 11.1 ± lOA (3.1-40.5), 10.-1 Y 7 deficientes (GHD). Se realizó pruebé secuencial de arginina-donidina en dos ocasiones, previo tratamiento con estradiol (E2 1-2 mg,oral). e placebo durante 3 días. Se detenninó GH max en 58 muestras por RlA (desarrollado, dosis minimé detectable, ´D,MD: 1.0 ugIL), lRMA (Serono, MAlA, DlVID: 0.15 ugIL) e JB..1A (DELFIA, DMD O.OlugIL).Resultados: La correlación entre los tres métodos fue altamente significativa: IRMA vs RlA r=0.97, IFMA ´,´sRIA, r=O.93 e IFMA vs IRMA, r=0.97, p<O.OOJ). El nivel medio GH max (X±DS)) el intervalo de confianza del 95% en los niños con SS fueron: bajo placebo 11.1 ± lOA (3.1-40.5), 10.-1± lOA (3.1-40.5), 10.-1 ± 12.6 (2.2-49) Y 4.4 ± 11 (0.71-27) IlgIL Y awnentaron significativamente con E2 (P<0.05): 18.0 :f:12.6 (2.2-49) Y 4.4 ± 11 (0.71-27) IlgIL Y awnentaron significativamente con E2 (P<0.05): 18.0 :f: 10.7 (7.2-45), 17.8 ± 12..+ (6.3-50.1) Y 8.2 ± 7.3 (2.3-28.5) IlgIL usando RIA, IRMA e IFMA respectivamente. Bajo placebo. en 3/7 niños del grupo GHD (con RlA e IRMA) y en 4/7 (con Iflv1A) e] nivel de GH max superó el límite inferior del intervalo de confianza de los SS. Luego de la sensibilización con E2 sólo 1/7 con RlA y cn ningún caso conill..t
A e IFMA se alcanzó un nlvcl dcntrc de los límites fiel intervalo de confianza para el grupo SS. Conclusiones~ La sensibilización con estradiol mejoró el diagnóstico de insuficiencia de GH utilizando los tres IE. Sin embargo el empleo d( IE más sensibles y específicos no resultó en una mejor discriminación entre los grupos estudiados. PERFORMA-NCE OF DIFFERENT IMMUNOASSA YS FOR GROWTH HORMONE (GH) !N THE DIAGNOSIS OF GB DEFICIENCY: MG Ropelato, KM Domené. A Martíncz, ME Escobar, P Pennisi, H Jasper, JJ Heinrich. División de Endocrinología. CEDlE. Hospit31 de Niños DI. R. Gutrrez. Buenos Aires. Argentina. High degree of variability has becn reported in the measurement of growth hormone (GH; using immunoassays (lA) ´>1th different sensitiYity and specificity. TIle aim of trus study ",,-as te evaluate the maxil11al GH leyel (GH 111ax)in response to provocative test by measu.ring GH using thre( dL."´IerentlA and to compare tteir usefullness in the diagnosis of GH deficiency (GHD). Tventy niile short children, 22 without clinical apparence of GH deficiency (SS) and 7 GHD, were studied Sequential arginine-donidine test ,vere performed in two separate occasions under eitIler estradiol (EL dL."´IerentlA and to compare tteir usefullness in the diagnosis of GH deficiency (GHD). Tventy niile short children, 22 without clinical apparence of GH deficiency (SS) and 7 GHD, were studied Sequential arginine-donidine test ,vere performed in two separate occasions under eitIler estradiol (EL respectivamente. Bajo placebo. en 3/7 niños del grupo GHD (con RlA e IRMA) y en 4/7 (con Iflv1A) e] nivel de GH max superó el límite inferior del intervalo de confianza de los SS. Luego de la sensibilización con E2 sólo 1/7 con RlA y cn ningún caso conill..t
A e IFMA se alcanzó un nlvcl dcntrc de los límites fiel intervalo de confianza para el grupo SS. Conclusiones~ La sensibilización con estradiol mejoró el diagnóstico de insuficiencia de GH utilizando los tres IE. Sin embargo el empleo d( IE más sensibles y específicos no resultó en una mejor discriminación entre los grupos estudiados. PERFORMA-NCE OF DIFFERENT IMMUNOASSA YS FOR GROWTH HORMONE (GH) !N THE DIAGNOSIS OF GB DEFICIENCY: MG Ropelato, KM Domené. A Martíncz, ME Escobar, P Pennisi, H Jasper, JJ Heinrich. División de Endocrinología. CEDlE. Hospit31 de Niños DI. R. Gutrrez. Buenos Aires. Argentina. High degree of variability has becn reported in the measurement of growth hormone (GH; using immunoassays (lA) ´>1th different sensitiYity and specificity. TIle aim of trus study ",,-as te evaluate the maxil11al GH leyel (GH 111ax)in response to provocative test by measu.ring GH using thre( dL."´IerentlA and to compare tteir usefullness in the diagnosis of GH deficiency (GHD). Tventy niile short children, 22 without clinical apparence of GH deficiency (SS) and 7 GHD, were studied Sequential arginine-donidine test ,vere performed in two separate occasions under eitIler estradiol (EL dL."´IerentlA and to compare tteir usefullness in the diagnosis of GH deficiency (GHD). Tventy niile short children, 22 without clinical apparence of GH deficiency (SS) and 7 GHD, were studied Sequential arginine-donidine test ,vere performed in two separate occasions under eitIler estradiol (EL ± 12..+ (6.3-50.1) Y 8.2 ± 7.3 (2.3-28.5) IlgIL usando RIA, IRMA e IFMA respectivamente. Bajo placebo. en 3/7 niños del grupo GHD (con RlA e IRMA) y en 4/7 (con Iflv1A) e] nivel de GH max superó el límite inferior del intervalo de confianza de los SS. Luego de la sensibilización con E2 sólo 1/7 con RlA y cn ningún caso conill..t
A e IFMA se alcanzó un nlvcl dcntrc de los límites fiel intervalo de confianza para el grupo SS. Conclusiones~ La sensibilización con estradiol mejoró el diagnóstico de insuficiencia de GH utilizando los tres IE. Sin embargo el empleo d( IE más sensibles y específicos no resultó en una mejor discriminación entre los grupos estudiados. PERFORMA-NCE OF DIFFERENT IMMUNOASSA YS FOR GROWTH HORMONE (GH) !N THE DIAGNOSIS OF GB DEFICIENCY: MG Ropelato, KM Domené. A Martíncz, ME Escobar, P Pennisi, H Jasper, JJ Heinrich. División de Endocrinología. CEDlE. Hospit31 de Niños DI. R. Gutrrez. Buenos Aires. Argentina. High degree of variability has becn reported in the measurement of growth hormone (GH; using immunoassays (lA) ´>1th different sensitiYity and specificity. TIle aim of trus study ",,-as te evaluate the maxil11al GH leyel (GH 111ax)in response to provocative test by measu.ring GH using thre( dL."´IerentlA and to compare tteir usefullness in the diagnosis of GH deficiency (GHD). Tventy niile short children, 22 without clinical apparence of GH deficiency (SS) and 7 GHD, were studied Sequential arginine-donidine test ,vere performed in two separate occasions under eitIler estradiol (EL dL."´IerentlA and to compare tteir usefullness in the diagnosis of GH deficiency (GHD). Tventy niile short children, 22 without clinical apparence of GH deficiency (SS) and 7 GHD, were studied Sequential arginine-donidine test ,vere performed in two separate occasions under eitIler estradiol (EL by measu.ring GH using thre( dL."´IerentlA and to compare tteir usefullness in the diagnosis of GH deficiency (GHD). Tventy niile short children, 22 without clinical apparence of GH deficiency (SS) and 7 GHD, were studied Sequential arginine-donidine test ,vere performed in two separate occasions under eitIler estradiol (EL(EL J-2 mg!d, p.o. for three days) or placebo pretreatment. GH max was determined in 58 serum samples b) RIA (in house assay, minima! detection dase, tvIDD: 1 ¡.¡gIL), IRJvfA (Serono, MAlA, tvIDD: 0.15 IlgIL: and IFMA· (DELFIA MDD: 0.01 ¡J.gIL). Rcsults: Significant correJations were found a.mong th( diffcrcnt mcth~ uscd (ill.tv1A vs RlA, r=0.97; IFMA vs RlA, r=0.93; I.Th1A vs IRMA r=0.97 p<O.OO1): Estrogen pretreatment have a similar stimulatory efIect on both mean levels of GH roa., anc the lower limit of95% confident límits measured by clifferent lA. On placebo: 11.1 ± lOA (3.1-40.5) lOA ± 12.6 (2.2-49) y.f.4 ± 11 (0.71-27) IlgIL; on El: 18.0 ± 10.7 (7.2-45),17.8 ± 12.4 (6.3-50.1) anc 8.2 ± 7.3 (2.3-28.5) ¡.¡.gIL(P<0.05) using RIA, IRMA and IFMA respectively. Without E2-priming, 3 te 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. 8.2 ± 7.3 (2.3-28.5) ¡.¡.gIL(P<0.05) using RIA, IRMA and IFMA respectively. Without E2-priming, 3 te 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. the lower limit of95% confident límits measured by clifferent lA. On placebo: 11.1 ± lOA (3.1-40.5) lOA ± 12.6 (2.2-49) y.f.4 ± 11 (0.71-27) IlgIL; on El: 18.0 ± 10.7 (7.2-45),17.8 ± 12.4 (6.3-50.1) anc 8.2 ± 7.3 (2.3-28.5) ¡.¡.gIL(P<0.05) using RIA, IRMA and IFMA respectively. Without E2-priming, 3 te 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. 8.2 ± 7.3 (2.3-28.5) ¡.¡.gIL(P<0.05) using RIA, IRMA and IFMA respectively. Without E2-priming, 3 te 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. p<O.OO1): Estrogen pretreatment have a similar stimulatory efIect on both mean levels of GH roa., anc the lower limit of95% confident límits measured by clifferent lA. On placebo: 11.1 ± lOA (3.1-40.5) lOA ± 12.6 (2.2-49) y.f.4 ± 11 (0.71-27) IlgIL; on El: 18.0 ± 10.7 (7.2-45),17.8 ± 12.4 (6.3-50.1) anc 8.2 ± 7.3 (2.3-28.5) ¡.¡.gIL(P<0.05) using RIA, IRMA and IFMA respectively. Without E2-priming, 3 te 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. 8.2 ± 7.3 (2.3-28.5) ¡.¡.gIL(P<0.05) using RIA, IRMA and IFMA respectively. Without E2-priming, 3 te 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. the lower limit of95% confident límits measured by clifferent lA. On placebo: 11.1 ± lOA (3.1-40.5) lOA ± 12.6 (2.2-49) y.f.4 ± 11 (0.71-27) IlgIL; on El: 18.0 ± 10.7 (7.2-45),17.8 ± 12.4 (6.3-50.1) anc 8.2 ± 7.3 (2.3-28.5) ¡.¡.gIL(P<0.05) using RIA, IRMA and IFMA respectively. Without E2-priming, 3 te 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. 8.2 ± 7.3 (2.3-28.5) ¡.¡.gIL(P<0.05) using RIA, IRMA and IFMA respectively. Without E2-priming, 3 te 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. RlA, r=0.97; IFMA vs RlA, r=0.93; I.Th1A vs IRMA r=0.97 p<O.OO1): Estrogen pretreatment have a similar stimulatory efIect on both mean levels of GH roa., anc the lower limit of95% confident límits measured by clifferent lA. On placebo: 11.1 ± lOA (3.1-40.5) lOA ± 12.6 (2.2-49) y.f.4 ± 11 (0.71-27) IlgIL; on El: 18.0 ± 10.7 (7.2-45),17.8 ± 12.4 (6.3-50.1) anc 8.2 ± 7.3 (2.3-28.5) ¡.¡.gIL(P<0.05) using RIA, IRMA and IFMA respectively. Without E2-priming, 3 te 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. 8.2 ± 7.3 (2.3-28.5) ¡.¡.gIL(P<0.05) using RIA, IRMA and IFMA respectively. Without E2-priming, 3 te 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. the lower limit of95% confident límits measured by clifferent lA. On placebo: 11.1 ± lOA (3.1-40.5) lOA ± 12.6 (2.2-49) y.f.4 ± 11 (0.71-27) IlgIL; on El: 18.0 ± 10.7 (7.2-45),17.8 ± 12.4 (6.3-50.1) anc 8.2 ± 7.3 (2.3-28.5) ¡.¡.gIL(P<0.05) using RIA, IRMA and IFMA respectively. Without E2-priming, 3 te 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. 8.2 ± 7.3 (2.3-28.5) ¡.¡.gIL(P<0.05) using RIA, IRMA and IFMA respectively. Without E2-priming, 3 te 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. 1): Estrogen pretreatment have a similar stimulatory efIect on both mean levels of GH roa., anc the lower limit of95% confident límits measured by clifferent lA. On placebo: 11.1 ± lOA (3.1-40.5) lOA ± 12.6 (2.2-49) y.f.4 ± 11 (0.71-27) IlgIL; on El: 18.0 ± 10.7 (7.2-45),17.8 ± 12.4 (6.3-50.1) anc 8.2 ± 7.3 (2.3-28.5) ¡.¡.gIL(P<0.05) using RIA, IRMA and IFMA respectively. Without E2-priming, 3 te 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. 8.2 ± 7.3 (2.3-28.5) ¡.¡.gIL(P<0.05) using RIA, IRMA and IFMA respectively. Without E2-priming, 3 te 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. ± 12.6 (2.2-49) y.f.4 ± 11 (0.71-27) IlgIL; on El: 18.0 ± 10.7 (7.2-45),17.8 ± 12.4 (6.3-50.1) anc 8.2 ± 7.3 (2.3-28.5) ¡.¡.gIL(P<0.05) using RIA, IRMA and IFMA respectively. Without E2-priming, 3 te 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. ± 7.3 (2.3-28.5) ¡.¡.gIL(P<0.05) using RIA, IRMA and IFMA respectively. Without E2-priming, 3 te 4 out 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays. 0[7 GHD patients showed values within the 95% CL for theSS group using the three differenl lA Estradiol-primed GH m~, reached the nOffilal values in only 1/7 by RlA and 0/7 by both IRMA anc IFMA Conc1usions: Estradiol-priming enllanced GHD diagnosis by GH provocative test using thw: different lA However, there was not a significant improvement using more sensitive and specifie assays.