Özge KÖPRÜLÜ, Elif Gökçe BASA, İbrahim Mert ERBAŞ, Fatma YAVUZYILMAZ ŞİMŞEK, Özlem NALBANTOĞLU, Hüseyin Anıl KORKMAZ, Behzat ÖZKAN
Journal of Clinical Research in Pediatric Endocrinology - 2026;18(1):138-144
Objective: Growth hormone (GH) deficiency (GHD) is a rare but important cause of short stature in children. Although GH stimulation tests remain the gold standard for diagnosis, establishing a definitive diagnosis continues to be challenging. Our aim was to evaluate the diagnostic performance of the peak-to-basal ratio and difference for identifying GHD in children. Methods: Patients with short stature who were evaluated for GHD with GH stimulation tests were retrospectively assessed. DeltaGH was defined as the difference between peak and basal GH levels. The GH ratio was calculated as the ratio of peak to basal GH levels. Results: Data were collected from 265 patients (182 prepubertal) with a median age at presentation of 10.6 years (interquartile range: 6.13-12.42), of whom 46.7% were female. In total, 146 patients met the diagnostic criteria for GHD. DeltaGH and GH ratio during the L-Dopa and Clonidine stimulation tests were significantly lower in the GHD group (p<0.001). A DeltaGH cut-off of <=7.08 in the clonidine test demonstrated excellent discriminative ability, with both sensitivity and specificity above 80%, and an area under the curve close to 0.9, suggesting that this parameter may may provide supportive diagnostic information for GHD. Conclusion: To the best of our knowledge, DeltaGH has been explored only in a limited number of studies. This study investigated diagnostic accuracy of difference (DeltaGH) or ratio of peak-to-basal GH on a large cohort of children with short stature. The supportive diagnostic performance observed in our cohort suggests that DeltaGH is clinically useful in routine practice.
