Recently, we have implemented the GH assay on Immulite 2000, which led to my
review of the reference interval. To make the long story short, I totally
eliminated the reference interval but included the following interpretation
in every report:
"An isolated GH level has little diagnostic value. Following stimulation by
insulin-induced hypoglycemia, a peak GH value < 5 µg/L in adults or <10 µg/L
in children is consistent with GH deficiency. Following suppression with 75g
of glucose taken orally, a GH value < 1 µg/L excludes the diagnosis of
acromegaly. Consult Endocrinology for further details."
PC Chan
Toronto
-----Original Message-----
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]]On Behalf Of Collins Wayne Dr
Sent: Wednesday, December 15, 2004 9:46 AM
To: [log in to unmask]
Subject: Growth hormone reference ranges
Recently I have been involved in the evaluation of serum Growth
Hormone on a DPC Immulite 2000. The kit insert suggests the following
reference ranges: Male 0 - 2.6 mIU/L and Female 0 - 26.0 mIU/L. I was
surprised at this.
I know the episodic secretion of GH makes reference ranges limited,
and there is evidence of gender differences in GH, but I would be
interested to know what existing users of the GH method on the Immulite
2000, or other GH methods, use (if any) for a Reference Range. (See "Marked
gender differences in ambulatory morning growth hormone values in yound
adults". Clinical Chemistry Vol 44 Number 6, 1998; 1289 - 1295. Britt Eden
Engstrom et al).
Furthermore, with such a difference in "normal" levels between the 2
sexes, should the interpretation of Dynamic Function Tests for growth
hormone excess or deficiency be gender based?
Wayne Collins
Principal Clinical Biochemist
Royal Preston Hospital
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