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GH deficiency was confirmed by low age- and sex-adjusted IGF-I levels and pituitary hormone deficiencies in 3 or more hormones (TSH, ACTH, LH/FSH, and/or arginine vasopressin) or, for those patients with fewer deficiencies, by one of the following stimulation tests with these cut points for peak GH levels: 1) arginine+GHRH (cut point 4.1 μg/L), 2) ITT (cut point 5.0 μg/L), 3) glucagon stimulation test (cut point 3.0 μg/L), or 4) arginine (cut point 0.4 μg/L) as recommended previously (1, 2, 4, 18)

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