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Test ID HGH Growth Hormone, Serum

Reporting Name

Growth Hormone, S

Useful For

Diagnosis of acromegaly and assessment of treatment efficacy (in conjunction with glucose suppression test)

 

Diagnosis of human growth hormone deficiency (in conjunction with growth hormone stimulation test)

Specimen Type

Serum


Specimen Required


Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 0.6 mL

Collection Instructions:

1. Fasting

2. If multiple specimens are drawn, submit each vial under a separate order.

3. Label specimens appropriately (corresponding draw time).


Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 7 days
  Frozen  90 days

Reference Values

Adults

Males: 0.01-0.97 ng/mL

Females: 0.01-3.61 ng/mL

Reference intervals have not been formally verified in-house for pediatric and adolescent patients. The published literature indicates that reference intervals for adult, pediatric, and adolescent patients are comparable.

 

For SI unit Reference Values, see https://www.mayomedicallaboratories.com/order-tests/si-unit-conversion.html.

Day(s) and Time(s) Performed

Monday through Friday 5 a.m. – 12 a.m., Saturday 6 a.m. – 6 p.m.

Test Classification

This test has been cleared or approved by the U.S. Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

83003

LOINC Code Information

Test ID Test Order Name Order LOINC Value
HGH Growth Hormone, S 2963-7

 

Result ID Test Result Name Result LOINC Value
HGH Growth Hormone, S 2963-7

Clinical Information

The anterior pituitary secretes human growth hormone (hGH) in response to exercise, deep sleep, hypoglycemia, and protein ingestion. hGH stimulates hepatic insulin-like growth factor-1 and mobilizes fatty acids from fat deposits to the liver. Hyposecretion of hGH causes dwarfism in children. Hypersecretion causes gigantism in children or acromegaly in adults.

 

Because hGH levels in normal and diseased populations overlap, hGH suppression and stimulation tests are needed to evaluate conditions of hGH excess and deficiency; random hGH levels are inadequate.

Interpretation

Acromegaly: For suppression testing, normal subjects have a nadir growth hormone (GH) concentration of <0.3 ng/mL after ingestion of a 75-gram glucose dose. Patients with acromegaly fail to show normal suppression. Using the Access ultrasensitive hGH assay, a cutoff of 0.53 ng/mL for nadir GH was found to most accurately differentiate patients with acromegaly in remission from active disease with a sensitivity of 97% (95% CI, 83%-100%) and a specificity of 100% (95% CI, 82%-100%).(1)

 

Deficiency: A normal response following stimulation tests is a peak GH concentration >5 ng/mL in children and >4 ng/mL in adults. For children, some experts consider GH values between 5 ng/mL and 8 ng/mL equivocal and only GH peak values >8 ng/mL as truly normal. Low levels, particularly under stimulation, indicate human growth hormone deficiency.

Clinical Reference

1. Bancos I, Algeciras-Schimnich A, Woodmansee WW, et al: Determination of nadir growth hormone concentration cutoff following oral glucose tolerance testing using the Beckman Coulter ultrasensitive growth hormone assay patients with newly diagnosed acromegaly, acromegaly in remission, and healthy subjects. Endocr Pract 2013 Jun 27:1-26 (Epub ahead of print)

2. Camacho-Hubner C: Assessment of growth hormone status in acromegaly: what biochemical markers to measure and how? Growth Hormone IGF Res 2000;10 Suppl B:S125-299

3. Nilsson AG: Effects of growth hormone replacement therapy on bone markers and bone mineral density in growth hormone-deficient adults. Horm Res 2000;54 Suppl 1:52-57

4. Strasburger CJ, Dattani MT: New growth hormone assays: potential benefits. Acta Paediatr 1997 Nov;Suppl 423:5-11

5. Okada S, Kopchick JJ: Biological effects of growth hormone and its antagonist. Trends Mol Med 2001Mar;7:126-132

6. Veldhuis JD, Iranmanesh A: Physiological regulation of human growth hormone (GH)-insulin-like growth factor type I (IGF-I) axis: predominant impact of age, obesity, gonadal function, and sleep. Sleep 1996;19:S221-224

Analytic Time

1 day

Method Name

Immunoenzymatic Assay