Criteria for diagnosis of growth hormone deficiency: Does it exist?

Objective: Exploration of the criteria for diagnosing hormone deficiency us ed by physicians practicing in Saudi Arabia. Methods: A questionnaire addressing the issue of criteria for diagnosing gr owth hormone deficiency was distributed to 104 physicians practicing in Sau di Arabia who were attending a course in endocrinology. Analysis of the dat a received from 48 physicians was carried out. Results: Only one criteria from 10 clinical and biochemical criteria was ch osen by 2 (4%), 2 by 9 (19%), 3 by 8 (17%), 4 by 15 (31%), 5 by 9 (19%), 6 by 2 (4%) and 7 by 3 (6%) physicians. The majority, 31 (65%) chose subnorma l growth velocity as an important criteria. Twenty-four (50%) chose the sub normal physiological growth hormone values taken during sleep or after vigo rous exercise, 26 (54%) chose the 2 provocative pharmacological tests, and 18 (37.5%) and 9 (19%) chose one and 3 pharmacological tests. Subnormal ran dom single growth hormone measurement was chosen by 8 (17%) physicians. Low somatomedin C (IgF1) and subnormal IgF1 binding proteins were the choice o f 18 (37.5%) and 4 (8%). Favorable biochemical response to growth hormone w as the choice of 16 (33%). When the choices were combined only 3 (6%) physi cians took the most likely correct combination choice ie subnormal growth v elocity, delayed bone age coupled with subnormal growth hormone values take n during sleep or exercise, and 2 provocative pharmacological tests. Conclusion: Definite diagnostic criteria for growth hormone deficiency is l acking in this country. A nationwide criteria, and subsequent central contr ol of growth hormone is required.