An assessment of endocrine function in boys with Perthes' disease.

The frequent association of short stature and retardation of skeletal maturation in Perthes' disease has prompted an investigation of growth-related hormones in this condition. A group of 18 prepubertal boys, aged five to 11 years, who either had a bone age two years or more less than their chronologic age or whose heights were less than the third centile, were studied. Their serum growth hormone (Se GH) response to insulin-induced hypoglycemia was significantly reduced, compared with a control group of short boys. They also demonstrated a tendency to elevated levels of somatomedin activity, measured by chick cartilage bioassay. Thyroid function was normal. These findings suggest a defect in the pituitary-somatomedin-target tissue axis in Perthes' disease.

Somatomedin in growth disorders and chronic renal insufficiency in children.

Somatomedin activity was measured using an embryonic chick cartilage assay in 33 normal and short normal children, 23 children with pituitary growth hormone (GH) deficiency, 14 children with sexual precocity, and 13 children with chronic renal insufficiency. In normal children somatomedin activity correlated well with chronological age: low valles in early childhood rose to higher than adult levels at puberty. Children with GH deficiency had significantly lower activities and those with sexual precocity significantly higher activities than normal children. In all three groups somatomedin activity correlated well with bone age. In children with chornic renal insufficiency there was a significant correlation between decreasing somatomedin activity and both a reduced growth velocity and a falling glomerular filtration rate. Somatomedin activity and growth velocity were within normal limits in children with glomerular filtration rates above 30 ml/min/1-73 m2.