Diagnosis of acromegaly and assessment of treatment efficacy when interpreted in conjunction with results from glucose suppression test
Diagnosis of human growth hormone deficiency when interpreted in conjunction with results from growth hormone stimulation test
This test is not intended for use as a screen for acromegaly.
This test has limited value in assessing growth hormone secretion in normal children.
Immunoenzymatic Assay
Growth Hormone Provocative Test
Growth Hormone Stimulation
hGH (Human Growth Hormone)
Human Growth Hormone
Somatotrophic Hormone
Somatotropin
Serum
The recommended test for assessing growth hormone secretion in normal children is IGF1I / Insulin-Like Growth Factor 1, Serum.
The preferred test for acromegaly screening is IGF1 / Insulin-Like Growth Factor 1, Serum.
Patient Preparation: Fasting, 8 hours
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.6 mL
Collection Instructions:
1. If multiple specimens are collected, submit each vial under a separate order.
2. Label specimens appropriately with the corresponding collection times.
If not ordering electronically, complete, print, and send an Oncology Test Request (T729) with the specimen.
0.5 mL
Gross hemolysis | Reject |
Gross lipemia | OK |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 7 days | |
Frozen | 90 days |
Diagnosis of acromegaly and assessment of treatment efficacy when interpreted in conjunction with results from glucose suppression test
Diagnosis of human growth hormone deficiency when interpreted in conjunction with results from growth hormone stimulation test
This test is not intended for use as a screen for acromegaly.
This test has limited value in assessing growth hormone secretion in normal children.
The anterior pituitary secretes human growth hormone (hGH)
Because hGH levels in normal and diseased populations overlap,
Adults
Males: 0.01-0.97 ng/mL
Females: 0.01-3.61 ng/mL
For SI unit Reference Values, see https://www.mayocliniclabs.com/order-tests/si-unit-conversion.html
Acromegaly: For suppression testing, normal subjects have a nadir human growth hormone (hGH) concentration below 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 hGH 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 hGH concentration above 5 ng/mL in children and above 4 ng/mL in adults. For children, some experts consider hGH values between 5 ng/mL and 8 ng/mL equivocal and only GH peak values greater than8 ng/mL as truly normal. Low levels, particularly under stimulation, indicate hGH deficiency.
As the hGH test has limited value in assessing growth hormone secretion in normal children, IGF1I / Insulin-Like Growth Factor 1, Serum is recommended as the first test for assessing deficient or excess growth during childhood and adolescent development. IGF1 reference intervals for Tanner stages are available. Suspected causes of dwarfism should be diagnosed with the aid of provocative testing.
Elevated levels of human growth hormone indicate the possibility of gigantism or acromegaly, but must be confirmed with stimulation and suppression testing.
Growth hormone is secreted in surges; single measurements are of limited diagnostic value.
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
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
7. Melmed S: Pathogenesis and diagnosis of growth hormone deficiency in adults. N Engl J Med 2019 Jun 27;380(26):2551-2562. doi: 10.1056/NEJMra1817346
The instrument used is the Beckman Coulter UniCel DXI 800. The Access Ultrasensitive human growth hormone (hGH) assay is a simultaneous one-step immunoenzymatic ("sandwich") assay. A sample is added to a reaction vessel along with polyclonal goat anti-hGH alkaline phosphatase conjugate and paramagnetic particles coated with mouse monoclonal anti-hGH antibody. The patient sample hGH binds to the monoclonal anti-hGH on the solid phase, while the goat anti-hGH-alkaline phosphatase conjugate reacts with a different antigenic site on patient sample hGH. After incubation in a reaction vessel, materials bound to the solid phase are held in a magnetic field while unbound materials are washed away. Then, the chemiluminescent substrate Lumi-Phos 530 is added to the vessel and light generated by the reaction is measured with a luminometer. The light production is directly proportional to the concentration of hGH in the sample. The amount of analyte in the sample is determined from a stored, multi-point calibration curve.(Package insert: Beckman Coulter Inc, Fullerton, CA, 03/2019)
Monday through Friday
This test has been cleared, approved, or is exempt by the US 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.
83003
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
HGH | Growth Hormone, S | 2963-7 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
HGH | Growth Hormone, S | 2963-7 |