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MATERIALS AND METHODS 1. Subjects This retrospective study was done by reviewing the medical records of children who visited the pediatric endocrine clinic at Chonnam National University Hospital. A total of 120 children with short stature who completed a GH stimulation test from January 2006 to April 2014 were enrolled in this study. All patients had a height less than the third percentile. Children with central nervous system neoplasms, multiple pituitary hormone deficiencies, and hypothyroidism were excluded. Children who had been taking drugs that may affect endogenous GH secretion, such as antipsychotic drugs and corticosteroids, and children with congenial disorder (e.g., Russel-Silver syndrome) were also excluded. GH deficiency was defined as a serum peak GH check details concentration Protein Tyrosine Kinase inhibitor with provocation. Data for height, weight, pubertal status, insulin-like growth factor (IGF-1), insulin-like growth factor binding protein (IGFBP)-3, thyroid function, and peak GH levels after stimulation were collected. Pubertal status was assessed by Tanner stage of breast development for females and genital development for males. Bone age was evaluated by the method of Greulich and Pyle.11 All GHD subjects had normal magnetic resonance imaging findings of the hypothalamic-pituitary region. This study was approved by the Institutional Review Board of our hospital (CNUH-2014-295). S6 Kinase 2. GH stimulation test After an overnight fast, an intravenous cannula was inserted. All provocation tests were performed in the morning hours with a 1-day interval between the two stimulation tests. To assess GH secretion, dopamine (Sinemet?, MSD, Whitehouse Station, NJ, USA; body weight more than 30 kg, 500 mg; body weight 15 to 30 kg, 250 mg; body weight less than 15 kg, 125 mg of L-dopa) was administered orally. Blood samples were drawn immediately before the medication and 30, 45, 60, 90, and 120 minutes later to obtain the serum GH concentration for each time point. Insulin (0.1 IU/kg) was administered as an intravenous bolus at time 0 to induce a fall in the blood glucose level to 50 mg/dL or less (or one-half of the baseline glucose level). Blood samples were obtained immediately before injection and at 15, 30, 45, 60, 90, and 120 minutes after injection. No patients were primed with sex steroids before the provocation tests. 3. Hormone assays GH levels were measured by IRMA with the detection limit of 0.03 IU/mL. The intra-assay coefficients of variation (CVs) were 1.3% to 2.1%, and the inter-assay CVs were 3.8% to 5.0% (Cisbio Bioassays, France). Serum IGF-1 levels were measured by using an IRMA with an analytical sensitivity of 2 ng/mL, intra-assay CV of 2.4% to 6.