Clinical Diagnosis and Stimulation Protocols
In Italy, the diagnosis of GHD follows strict national and international consensus guidelines (such as those from the Italian Society for Pediatric Endocrinology and Diabetes - SIEDP). Diagnosis is not based on a single measure but on a combination of clinical, biochemical, and radiological findings.
Clinical Indicators: Severe short stature (more than 3 standard deviations below the mean) or a significant drop in growth velocity.
Biochemical Testing: At least two different "provocative" stimulation tests (e.g., using Arginine, Glucagon, or Insulin) are required to confirm insufficient growth hormone (GH) secretion. A peak GH level below a specific cut-off (usually $8-10$ ng/mL in children) is indicative of deficiency.
IGF-1 Measurement: Serum levels of Insulin-like Growth Factor-1 are used as a key biomarker, though they are always interpreted alongside the stimulation test results.