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To evaluate recombinant growth hormone (rGH) long-term response and retesting results in three different groups of children divided in accordance with the biochemical criteria of initial diagnosis. Height gain (\u2206HT) at adult height (AH) and retesting results were evaluated in 57 rGH treated children (M\u2009=\u200934, 59.6%) divided into 3 groups according to initial diagnosis: Group A (n\u2009=\u200925) with max GH peak at stimulation test\u2009&lt;\u20098\u00a0\u00b5g\/L, Group B (n\u2009=\u200919) between 8 and 10\u00a0\u00b5g\/L and Group C (n\u2009=\u200913) with mean overnight GH\u2009&lt;\u20093\u00a0\u00b5g\/L (neurosecretory dysfunction, NSD). Retesting was carried out in all patients after at least one month off therapy upon reaching the AH. 40\/57 (70.2%) patients were pre-pubertal at diagnosis and showed \u2206HT of 1.37\u2009\u00b1\u20091.00 SDS, with no significant differences between groups (<jats:italic>P<\/jats:italic>\u2009=\u20090.08). Nonetheless, 46% patients in Group B showed \u2206HT\u2009&lt;\u20091SDS (vs 13% and 12% in Group A and C, respectively) and 25% children failed to reach mid-parental height (vs 6% and 0% in Group A and C, respectively). At AH attainment, IGHD was reconfirmed in 28% (7\/25) and 10% (2\/19) in Group A and B, respectively. A reduction of diagnostic cut-off at GH stimulation tests could better discriminate between \u201cgood\u201d and \u201cpoor responders\u201d and predict the persistence of IGHD through transition. Group C response and the predictive value of baseline IGF-I SDS bring back to light NSD: should we consider an underlying hypothalamic derangement when the clinical presentation is strongly consistent with IGHD but pharmacological stimulation test is normal?<\/jats:p>","DOI":"10.1038\/s41598-021-93963-6","type":"journal-article","created":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T10:03:50Z","timestamp":1626343430000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Influence of biochemical diagnosis of growth hormone deficiency on replacement therapy response and retesting results at adult height"],"prefix":"10.1038","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2200-9538","authenticated-orcid":false,"given":"Giulia","family":"Rodari","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Profka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Giacchetti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I.","family":"Cavenaghi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Arosio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Giavoli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,7,15]]},"reference":[{"key":"93963_CR1","unstructured":"National Institute for Health and Clinical Excellence. 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