A COMPARATIVE STUDY OF SERUM GROWTH HORMONE AND PLASMA CORTISOL LEVELS IN STIMULATION TESTS WITH INSULIN AND PROPRANOLOL-GLUCAGON

1975 ◽  
Vol 80 (1) ◽  
pp. 70-80 ◽  
Author(s):  
W. Andler ◽  
G. Biro ◽  
S. Bernasconi ◽  
G. Giovanelli
Keyword(s):  
Growth Hormone ◽  
Plasma Cortisol ◽  
Normal Growth ◽  
Poor Response ◽  
Adrenocortical Function ◽  
Insulin Stimulation ◽  
Normal Response ◽  
Maximum Increase ◽  
Serum Growth Hormone ◽  
Stimulation Tests

ABSTRACT Insulin and propranolol-glucagon stimulation tests were carried out on 28 children and 5 adolescents and the results of their growth hormone and plasma cortisol estimations were compared. Twenty-nine subjects with normal growth hormone reserves showed a mean maximum rise of 17.4 μU/ml of serum growth hormone in the insulin test whereas the intramuscular injection of glucagon after oral premedication with propranolol produced a rise of 38.5 μU/ml. Five subjects with normal growth hormone reserves showed a reduced hormone output in the insulin stimulation tests but normal response in the propranolol-glucagon stimulation tests. Only one subject showed a poor response in the propranolol-glucagon but normal response in the insulin stimulation test. In 30 subjects with normal adrenocortical function the mean maximum increase of plasma cortisol was 15.6 μU/ml in the insulin – and 14.9 μU/ml in the propranolol-glucagon stimulation tests, respectively. Both methods are suitable for studying the pituitary-adrenocortical interrelationships. The mechanism of the release of glucagon-induced growth hormone is not clear but the fall in blood glucose does not seem to play a major role in the process. A stress-like mechanism is equally unlikely because vegetative symptoms occurred only i a small number of subjects after intramuscular glucagon administration. It is possible that glucagon possesses a releasing-like mechanism which operates in the pituitary itself.

Acromegaly in an Infant

PEDIATRICS ◽  
1989 ◽  
Vol 83 (6) ◽  
pp. 998-1002
Author(s):  
Denise L. Blumberg ◽  
Charles A. Sklar ◽  
Raphael David ◽  
Saul Rothenberg ◽  
Jennifer Bell
Keyword(s):  
Growth Hormone ◽  
Hormone Level ◽  
Growth Hormone Level ◽  
Normal Growth ◽  
Bone Age ◽  
Serum Growth Hormone ◽  
Somatomedin C ◽  
Hormone Levels ◽  
Preoperative Serum ◽  
Stimulation Tests

Serial hormonal studies were carried out in a girl with a growth hormone-secreting pituitary adenoma and hyperprolactinemia diagnosed at 21 months of age, the youngest verified case of acromegaly. The child had progressive macrocephaly, noted at 6 months of age, which preceded the rapid acceleration of linear growth by nearly 1 year. At 21 months of age, the girl's head circumference measured 55 cm (+5.5 SD) and her height was 97.6 cm (+4.4 SD). Preoperative serum growth hormone level was 135 ng/mL, somatomedin C was 1,540 ng/mL (normal for bone age 18 to 97 ng/mL), and prolactin was 370 ng/mL (normal < 20 ng/mL). Following total resection of a large adenoma, immunohistochemical staining of the tumor showed growth hormone but not prolactin. With longitudinal monitoring of the child for 2 years postoperatively, persistently low growth hormone levels were demonstrated and normal growth velocity (6 cm/yr). Peak serum growth hormone levels ranged from 2.8 to 4.1 ng/mL after stimulation tests with insulin, arginine, and L-dopa. Maximum sleep-entrained growth hormone level was 3.4 ng/mL. At the same time, serum somatomedin C levels measured serially were normal (29 to 111 ng/mL), whereas simultaneous prolactin levels were moderately increased (30 to 147 ng/mL). The data support the hypothesis that hyperprolactinemia may have contributed to stimulating somatomedin C and sustaining the normal growth rate in this child.

Do Short Children Secrete Insufficient Growth Hormone?

PEDIATRICS ◽  
1985 ◽  
Vol 76 (3) ◽  
pp. 355-360
Author(s):  
Zvi Zadik ◽  
Stuart A. Chalew ◽  
Salvatore Raiti ◽  
A. Avinoam Kowarski
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Normal Growth ◽  
Mean Value ◽  
Hormone Deficiency ◽  
Short Children ◽  
Stimulation Tests ◽  
Normal Stature ◽  
Hormone Responses ◽  
The Mean

The 24-hour integrated concentration of growth hormone from 46 children of normal stature was compared with that of 90 short children. Nineteen of the short children had classic growth hormone deficiency by standard pharmacologic growth hormone stimulation tests. Seventy-one children had normal growth hormone responses to stimulation. The mean integrated concentration of growth hormone for children with normal stature (6.6 ± 1.9 ng/mL) was greater than the mean value for those with normal stimulated growth hormone (3.8 ± 2.3 ng/mL) and greater than the mean value for those with growth hormone deficiency (1.6 ± 0.6 ng/mL); differences between groups were all statistically significant (P < .0001). Forty-five percent of children with normal stimulated growth hormone responses had integrated concentration of growth hormone within the range of values for the group with growth hormone deficiency; this finding may provide the explanation for their poor growth. Thus, patients with normal growth hormone responses have a spectrum of spontaneous growth hormone secretion ranging from normal to impaired. Recent reports indicate that children with normal growth hormone responses who have very low integrated concentration of growth hormone may have the potential to improve their growth with growth hormone therapy. Therefore, use of the integrated concentration of growth hormone may be a more effective method than standard pharmacologic stimulation tests for determining which short children are potentially able to respond to growth hormone therapy.

Acromegaly with normal growth-hormone levels and pituitary histology

1979 ◽  
Vol 50 (4) ◽  
pp. 503-507 ◽  
Author(s):  
Kenneth R. Feingold ◽  
Ira D. Goldfine ◽  
Philip R. Weinstein
Keyword(s):  
Growth Hormone ◽  
Continuous Monitoring ◽  
Sella Turcica ◽  
Normal Growth ◽  
Normal Range ◽  
Serum Growth Hormone ◽  
Content Type ◽  
Hormone Levels ◽  
Abnormal Growth ◽  
Fine Print

✓ In rare cases, acromegalic patients have normal basal concentrations of growth hormone, and their acromegaly results from abnormal growth-hormone secretory patterns. A patient is reported with the clinical features of acromegaly, who had elevated somatomedin levels and an enlarged sella turcica, but whose serum growth-hormone levels on continuous monitoring were in the normal range, with levels of 2.8 to 8.9 ng/ml. Dynamic studies of growth hormone revealed normal responses to hypo- and hyperglycemia, but abnormal responses to L-dopa and thyroid-releasing hormone. At surgery, neither a pituitary adenoma nor eosinophilic hyperplasia was present. It is likely that this patient's acromegaly resulted from the presence of chronically high normal levels of growth hormone.

HYPOTHALAMIC ENDOCRINE DYSFUNCTION IN ANOREXIA NERVOSA

1977 ◽  
Vol 85 (4) ◽  
pp. 673-683 ◽  
Author(s):  
Antti Aro ◽  
B.-A. Lamberg ◽  
Risto Pelkonen
Keyword(s):  
Growth Hormone ◽  
Anorexia Nervosa ◽  
Diurnal Variation ◽  
Plasma Cortisol ◽  
Free Thyroxine ◽  
Inadequate Response ◽  
Serum Growth Hormone ◽  
Hormone Levels ◽  
Free Thyroxine Index ◽  
The Mean

ABSTRACT The hypothalamic-pituitary function of 21 women with anorexia nervosa, aged 15–34 years, was studied. The tests included, in addition to the usual tests of thyroid function, a TRH stimulation test with 200 μg of synthetic TRH given iv; the response of serum immunoreactive growth hormone to insulin; and the diurnal variation and response of plasma cortisol to insulin hypoglycaemia. The mean serum TSH level of the patients was higher than that of healthy controls. The mean maximal increment of TSH after TRH was similar in the patients and the controls. However, 18 of the patients but none of the controls showed a delayed TSH-response to TRH, i. e. the TSH-level at 60 min was higher than that recorded 20 min after TRH. Four of the patients had a low free thyroxine index, computed from the PBI and T3 Sephadex uptake values, and 3 of these were clinically hypothyroid. The means for PBI, T4 and the free thyroxine index were all significantly below the means for the controls. The basal serum growth hormone levels were increased in 9 out of 17 patients. In 4 of these an inadequate response to insulin or to glucagon was found. In 5 out of the 8 patients with normal basal growth hormone levels a normal response was found, whereas the remaining 3 showed a subnormal response. The serum growth hormone level was correlated with the degree of weight loss but not with the serum albumin concentration. Plasma cortisol at 08.00 was increased in 9 patients and the diurnal variation was inadequate in 6. Four patients showed a subnormal response to insulin-induced hypoglycaemia, and 2 out of 5 patients tested failed to show adequate suppression of plasma cortisol after 1 mg of dexamethasone. Dysfunction of the hypothalamic-pituitary axis is common in anorexia nervosa. A delayed TSH-response to TRH, compatible with hypothalamic dysfunction, seems to be an almost consistent feature of the disorder, and in some of the patients even clinical hypothalamic hypothyroidism may be evident.

CORRELATIVE STUDY OF RADIORECEPTOR ASSAY AND RADIOIMMUNOASSAY OF SERUM GROWTH HORMONE IN CHILDREN: NORMAL CHILDREN AND HGH -TREATED PITUITARY DWARFS

1977 ◽  
Vol 86 (1) ◽  
pp. 50-59 ◽  
Author(s):  
Philippe E. Garnier ◽  
Jean-Claude Job ◽  
A. M. Repellin
Keyword(s):  
Growth Hormone ◽  
Human Growth ◽  
Cross Reactivity ◽  
Radioreceptor Assay ◽  
Normal Children ◽  
Serum Growth Hormone ◽  
Human Prolactin ◽  
Before And After ◽  
Stimulation Tests ◽  
Comparison Of The Results

ABSTRACT A sensitive and reproducible radioreceptor assay (RRA) for human growth hormone (HGH) is described. It allows the evaluation of HGH concentrations as low as 2 ng/ml. It has a limited cross-reactivity with human prolactin, which does not interfere at physiological levels in children. Comparison of the results with those of radioimmunoassay (RIA) showed no discrepancies in the serum of normal children before and after stimulation tests for GH (mean RRA/RIA ratio 1.03 ± sem 0.04, range 0.75 to 1.65) nor in the serum from hypopituitary dwarfs during the 12 h following an im injection of 6 mg of HGH (mean RRA/RIA ratio 1.05 ± sem 0.04, range 0.84 to 1.28). It is concluded that receptoractivity of HGH is parallel to its immunoreactivity in normal children and in hypopituitary patients receiving clinical grade HGH.

A RAPID TEST OF ADRENOCORTICAL FUNCTION USING HOMACTID (SYNTHETIC αh1–28 ACTH)

1971 ◽  
Vol 67 (3) ◽  
pp. 470-472 ◽  
Author(s):  
D. F. Woodings ◽  
P. Young
Keyword(s):  
Plasma Cortisol ◽  
Rapid Test ◽  
Plasma Cortisol Level ◽  
Adrenocortical Function ◽  
Adrenocortical Insufficiency ◽  
Normal Response ◽  
Short Test ◽  
The Mean ◽  
Synthetic Polypeptide ◽  
Single Plasma

ABSTRACT As a short test of adrenocortical function, plasma cortisol values were determined before, and 15 and 30 minutes after, a single intravenous injection of 10 μg of a synthetic polypeptide αh1–28 ACTH (HOMACTID) given between 9 and 10 a. m. Its usefulness in a screening test to exclude primary adrenocortical insufficiency is suggested based on a single plasma corticosteroid concentration obtained 30 minutes after the HOMACTID injection, a normal response being a level of greater than 19 μg/100 ml at this time. In 30 control subjects the mean plasma cortisol level rose by 8.9 (± se 0.8) μg/100 ml at 15 minutes and 12.0 (± se 0.9) μg/100 ml at 30 minutes from a resting value of 15.5 (± se 1.1) μg/100 ml. HOMACTID can thus be used as a quick test of adrenal function in the same way as Synacthen®.

scholarly journals Comparison of Serum Growth Hormone Levels after Bovril and Insulin Stimulation

1970 ◽  
Vol 45 (242) ◽  
pp. 544-546 ◽  
Author(s):  
D. B. Grant ◽  
D. Jackson ◽  
S. Raiti ◽  
B. E. Clayton
Keyword(s):  
Growth Hormone ◽  
Insulin Stimulation ◽  
Serum Growth Hormone ◽  
Hormone Levels
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