Introduction: Several studies have analyzed the association between the maximal growth hormone serum level obtained during a growth hormone stimulation test (GH-Max) and the body mass index standard deviation score (BMI-SDS). However, as sample sizes were quite small, our study aimed to analyze the association between GH-Max and BMI-SDS within a large cohort of 991 children. Further, we investigated other influencing factors, like test type, age, sex, puberty and preterm birth. Methods: Children with short stature (height < 10th percentile) received growth hormone stimulation tests with arginine or glucagon at the Department of Paediatric Endocrinology of the University of Leipzig Medical Center. The study population included a total of 1,438 tests (633 tests on girls, 805 tests on boys), with the majority consisting of prepubertal children (tests = 1,138). The mean age at testing was 7.74 years. Analyses were carried out on the entire cohort as well as stratified by test types. We performed univariate and multivariate analyses using linear mixed effect models to assess the effects on GH-Max. Results: GH-Max and BMI-SDS were significantly negatively associated with an effect size of ß = -1.10 (p < 0.001), independent from the test type. The GH-Max values were significantly (p < 0.001) higher for glucagon (mean value: 9.65 ng/ml) than those for arginine tests (mean value: 8.50 ng/ml). Age, sex, premature birth, and puberty were not significantly related to GH-Max values. Conclusion: We confirmed the negative association between GH-Max and weight status of short children found in previous studies. Therefore, considering BMI-SDS may be helpful in the assessment of growth hormone stimulation tests in short-statured children, but it should not be the determining factor for a treatment decision.


中文翻译：

---

体重指数对儿童生长激素刺激试验中生长激素峰值反应的影响

简介：多项研究分析了在生长激素刺激试验 (GH-Max) 期间获得的最大生长激素血清水平与体重指数标准差评分 (BMI-SDS) 之间的关联。然而，由于样本量非常小，我们的研究旨在分析 991 名儿童的大型队列中 GH-Max 和 BMI-SDS 之间的关联。此外，我们调查了其他影响因素，如测试类型、年龄、性别、青春期和早产。方法：身材矮小的儿童（身高 < 第 10 个百分位数）在莱比锡大学医学中心的儿科内分泌科接受了精氨酸或胰高血糖素的生长激素刺激试验。研究人群包括总共 1,438 项测试（633 项针对女孩的测试，805 项针对男孩的测试），大多数由青春期前的儿童组成（测试 = 1,138）。测试时的平均年龄为 7.74 岁。对整个队列进行了分析，并按测试类型进行了分层。我们使用线性混合效应模型进行单变量和多变量分析，以评估对 GH-Max 的影响。结果：GH-Max 和 BMI-SDS 与 ß = -1.10 (p < 0.001) 的效应大小显着负相关，独立于测试类型。胰高血糖素（平均值：9.65 ng/ml）的 GH-Max 值显着（p < 0.001）高于精氨酸测试（平均值：8.50 ng/ml）。年龄、性别、早产和青春期与 GH-Max 值无显着相关。结论：我们证实了先前研究中发现的矮个子儿童的 GH-Max 和体重状态之间的负相关。所以，