Is it possible to define normal growth hormone secretion?
A prevailing opinion has evolved which holds that GH stimulation tests utilized to assess endogenous GH secretory status produce a high percentage of both false negative and false positive results, thus rendering them unreliable and possibly unnecessary.23,24,39,40 A recent international report has extensively reviewed the difficulties in accurately making the diagnosis of GHD, and concluded that it was not possible to make this diagnosis in short slowly growing children.11 These authors unequivocally supported the therapeutic trial of GH in such children, irrespective of GH secretory status, which they concluded should not be utilized as a gold standard to determine GH administration. This report did not assess recent developments in GHRH testing or the potential diagnostic and therapeutic role of newer GH-releasing peptides (see below), nor did it adequately discuss the final height or psychological outcome of short children with “normal” GH secretion who have been treated following
