Physicians, therefore use a combination of indirect and direct criteria in assessing GHD, including:
Auxologic criteria (defined by body measurements)
Indirect hormonal criteria (IGF levels from a single blood sample)
Direct hormonal criteria (measurement of GH in multiple blood samples to determine secretory patterns or responses to provocative testing), in particular:
Subnormal frequency and amplitude of GH secretory peaks when sampled over several hours
Subnormal GH secretion in response to at least two provocative stimuli
Increased IGF1 levels after a few days of GH treatment
Response to GH treatment
Corroborative evidence of pituitary dysfunction"Provocative tests" involve giving a dose of an agent that will normally provoke a pituitary to release a burst of growth hormone. An intravenous line is established, the agent is given, and small amounts of blood are drawn at 15-minute intervals over the next hour to determine if a rise of GH was provoked. Agents which have been used clinically to stimulate and assess GH secretion are arginine, levodopa, clonidine, epinephrine and propranolol, glucagon, and insulin. An insulin tolerance test has been shown to be reproducible, age-independent, and able to distinguish between GHD and normal adults, and so is the test of choice.
Society and culture
Notable people
Zion Clark, American track athlete and wrestler, 2022 Guinness World Record holder (20m hand sprint in 4.78 seconds)
Rebecca Dubber, New Zealand para-swimmer and Rio 2016 Paralympic bronze medalist
Kenny Easterday, played a fictionalized version of himself in the film Kenny
Johnny Eck, American freak show performer
Kurt Fearnley, Australian wheelchair racer
Chloé Cooper Jones, American philosopher and author
Bobby Martin, American footballer
Kevin McKee, two-times Olympic champion and two-times world champion in sledge hockey
Sainimili Naivalu, Fijian wheelchair table tennis medallist and disability rights activists
Victoria Pendergast, first female Australian sit-skier at Winter Paralympics
Jessica Rogers, American wheelchair racer and swimmer, founder and President of iSACRA (International Caudal Regression Syndrome Association)
Rose Siggins, actress (American Horror Story: Freak Show)

References


== External links ==