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Use of Growth Hormone in Non-Growth-Hormone-Deficient Children: Physiologic, Pharmacologic, and Ethical Issues

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Abstract

The definitive diagnosis of growth hormone (GH) deficiency and the predetermined identification of short-statured children treatable with GH remain enigmas. The purpose of this chapter is to briefly summarize the physiology of GH secretion and relevant pharmacologic data as they relate to GH treatment. Last, some ethical issues regarding GH treatment in short children will be covered briefly.

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References

  1. Reiter EO, Morris AH, MacGillivray M, Weber D. Variable estimates of serum growth hormone concentrations by different radioassay systems. J Clin Endocrinol Metab 1988;66:68–71.

    Article  PubMed  CAS  Google Scholar 

  2. Celniker AC, Chen AB, Wert RM, Sherman BM. Variability in the quantitation of circulating growth hormone using commercial immunoassays. J Clin Endocrinol Metab 1989;68:469–76.

    Article  PubMed  CAS  Google Scholar 

  3. Tannenbaum GS. Interrelationship of somatostatin and growth hormone-releasing hormone in the genesis of the rhythmic secretion of growth hormone. Acta Paediatr Scand (Suppl) 1990;367:76–80.

    CAS  Google Scholar 

  4. Bafkan AL. Acromegaly. Trends Endocrinol Metab 1992;3:205–10.

    Article  Google Scholar 

  5. Cuttler L, Glaum SR, Collins BA, Miller RJ. Calcium signalling in single growth hormone-releasing factor-responsive pituitary cells. Endocrinology 1992;130:945–53.

    Article  PubMed  CAS  Google Scholar 

  6. Schonbrunn A. Somatostatin action in pituitary cells involves two independent transduction mechanisms. Metabolism 1990;39(suppl 2):96–100.

    Article  PubMed  CAS  Google Scholar 

  7. Devesa J, Lima L, Treaguerres JAF. Neuroendocrine control of growth hormone secretion in humans. Trends Endocrinol Metab 1992;3:175–83.

    Article  PubMed  CAS  Google Scholar 

  8. Castrillo JL, Theill LE, Krin M. Function of the homeodomain protein GHF1 in pituitary cell proliferation. Science 1991;253:197–9.

    Article  PubMed  CAS  Google Scholar 

  9. Wheeler MD, Syne DM. The nonhuman primate as a model of growth hormone physiology in the human being. Endocrinol Rev 1988;9:213–46.

    Article  CAS  Google Scholar 

  10. Bercu BB, Diamond FB. Growth hormone neurosecretory dysfunction. In: Servage M, Randall R, eds. Clin Endocrinol Metab 1986;15:537–90.

    Google Scholar 

  11. Holl RW, Hartman ML, Veldhuis JD, Taylor WM, Thorner MO. Thirty-second sampling of plasma growth hormone in man: correlation with sleep stages. J Clin Endocrinol Metab 1991;72:854–61.

    Article  PubMed  CAS  Google Scholar 

  12. Maghnie M, Triulzi F, Larizza D, et al. Hypothalamic-pituitary dysfunction in growth hormone-deficient patients with pituitary abnormalities. J Clin Endocrinol Metab 1991;73:79–83.

    Article  PubMed  CAS  Google Scholar 

  13. Iranmanesh A, Lizarralde G, Johnson ML, Veldhuis JD. Nature of altered growth hormone secretion in hypothyroidism. J Clin Endocrinol Metab 1991;72:108–15.

    Article  PubMed  CAS  Google Scholar 

  14. Glustina A, Wehrenberg WB. The role of glucocorticoids in the regulation of growth hormone secretion: mechanisms and clinical significance. Trends Endocrinol Metab 1992;3:306–11.

    Article  Google Scholar 

  15. Martha PM, Gorman KM, Blizzard RM, Rogol AD, Veldhuis JD. Endogenous growth hormone secretion and clearance rates in normal boys as determined by deconvolution analysis: relationship to age, pubertal status and body mass. J Clin Endocrinol Metab 1992;74:336–44.

    Article  PubMed  CAS  Google Scholar 

  16. Hartman ML, Veldhuis JD, Johnson ML, et al. Augmented growth hormone (GH) secretory burst frequency and amplitude mediate enhanced GH secretion during a two-day fast in normal men. J Clin Endocrinol Metab 1992;74: 757–65.

    Article  PubMed  CAS  Google Scholar 

  17. Veldhuis JD, Iranmanesh A, Ho KKY, Waters MJ, Johnson ML, Lizarralde G. Dual defects in pulsatile growth hormone secretion and clearance subserve the hyposomatotropism of obesity in man. J Clin Endocr Metab 1991;72: 51–9.

    Article  PubMed  CAS  Google Scholar 

  18. Heinze HJ, Bercu BB. Short stature and the patterns of growth hormone secretion. Endocrinologist 1993;3:331–43.

    Article  Google Scholar 

  19. Baumann G, Stolar MW, Amburn K, Barsano CP, Devries BC. A specific growth hormone-binding protein in human plasma: initial characterization. J Clin Endocrinol Metab 1986;62:134–41.

    Article  PubMed  CAS  Google Scholar 

  20. Herington AC, Ymer S, Stevenson J. Identification and characterization of specific binding proteins for growth hormone in normal human sera. J Clin Invest 1986;77:1817–23.

    Article  PubMed  CAS  Google Scholar 

  21. Baumann G. Growth hormone heterogeneity: genes, isohormones, variants and binding proteins. Endocr Rev 1991;12:424–49.

    Article  PubMed  CAS  Google Scholar 

  22. Martha PM, Rogol AD, Blizzard RM, Shaw MA, Baumann G. Growth hormone-binding protein activity is inversely related to 24-hour growth hormone release in normal boys. J Clin Endocrinol Metab 1991;73:175–81.

    Article  PubMed  CAS  Google Scholar 

  23. Martha PM, Reiter EO, Davila N, Shaw MA, Holcombe JH, Baumann G. Serum growth hormone (GH)-binding protein/receptor: an important determinant of GH responsiveness. J Clin Endocrinol Metab 1992;75:1464–9.

    Article  PubMed  Google Scholar 

  24. Baumann G, Shaw MA. A second, lower affinity growth hormone-binding protein in human plasma. J Clin Endocrinol Metab 1990;70:680–6.

    Article  PubMed  CAS  Google Scholar 

  25. Baumann G, Shaw MA, Amburn K. Regulation of plasma growth hormone-binding proteins in health and disease. Metabolism 1989;38:683–9.

    Article  PubMed  CAS  Google Scholar 

  26. Root AW, Martinez CR. Magnetic resonance imaging in patients with hypopituitarism. Trends Endocrinol Metab 1992;3:283–7.

    Article  PubMed  CAS  Google Scholar 

  27. Argropoulou M, Perignon F, Brauner R, Brunelle F. Magnetic resonance imaging in the diagnosis of growth hormone deficiency. J Pediatr 1992;120: 886–91.

    Article  Google Scholar 

  28. Strasburger C, Barnard G, Toldo L, et al. Somatotropin as measured by a two-site time-resolved immunofluorometric assay. Clin Chem 1989;35: 913–7.

    PubMed  CAS  Google Scholar 

  29. Marin G, Barnes KM, Rose S, et al. Responses to four growth hormone (GH) provocative tests in normal children and adolescents [Abstract]. Pediatr Res 1990;27:80.

    Article  Google Scholar 

  30. Marin G, Barnes KM, Domene H. Failure of normal prepubertal children to respond to growth hormone (GH) stimulation tests [Abstract]. Annu Endocr Soc meet 1991;128:82A.

    Google Scholar 

  31. Frasier AD. A review of growth hormone stimulation tests in children. Pediatrics 1974;53:929–37.

    PubMed  CAS  Google Scholar 

  32. Devesa J, Lima L, Lois N, et al. Reasons for the variability in growth hormone (GH) responses to GHRH challenge: the endogenous hypothalamic-somatotroph rhythm (HSR). Clin Endocrinol 1989;30:367–77.

    Article  CAS  Google Scholar 

  33. Cho KH, Yank SW, Hu CS, Bercu BB. Growth hormone (GH) responses to growth hormone-releasing hormone (GHRH) varied with intrinsic growth hormone secretory rhythm in children: reduced variability using somatostatin pretreatment. Pediatr Endocrinol 1992;5:155–65.

    Google Scholar 

  34. Dickerman F, Guyda H, Tannenbaum GS. Pretreatment with somatostatin analog SMS 201–995 potentiates growth hormone (GH) responsiveness to GH-releasing factor in short children. J Clin Endocrinol Metab 1993;77: 652–7.

    Article  PubMed  CAS  Google Scholar 

  35. Spiliotis B, August G, Hung W, Sonis W, Mendelsen W, Bercu BB. Growth hormone neurosecretory dysfunction: a treatable cause of short stature. JAMA 1984;251:2223–30.

    Article  PubMed  CAS  Google Scholar 

  36. Zadik Z, Chalew SA, Kowarski A. Assessment of growth hormone (GH) secretion in normal stature children using 24-hour integrated concentration of GH and pharmacological stimulation. J Clin Endocrinol Metab 1990;71: 932–6.

    Article  PubMed  CAS  Google Scholar 

  37. Lin TH, Kirkland RT, Sherman BM, Kirkland JL. Growth hormone testing in short children and their response to growth hormone therapy. J Pediatr 1989;115:57–63.

    Article  PubMed  CAS  Google Scholar 

  38. Rose SR, Ross JL, Uriarte M, Barnes KM, Cassorla FG, Cutler GB. The advantage of measuring stimulated as compared with spontaneous growth hormone levels in the diagnosis of growth hormone deficiency. N Engl J Med 1988;319:201–7.

    Article  PubMed  CAS  Google Scholar 

  39. Bercu BB, Shulman DI, Root AW, Spiliotis BE. Growth hormone provocative testing frequently does not reflect endogenous growth hormone secretion. J Clin Endocrinol Metab 1986;63:709–16.

    Article  PubMed  CAS  Google Scholar 

  40. Tassoni P, Cacciari E, Cau M, et al. Variability of growth hormone response to pharmacological and sleep tests performed twice in short children. J Clin Endocrinol Metab 1990;71:230–4.

    Article  PubMed  CAS  Google Scholar 

  41. Donaldson DL, Hollowell JG, Pan F, Gifford RA, Moore WV. Growth hormone secretory profiles: variation on consecutive nights. J Pediatr 1989; 115:51–6.

    Article  PubMed  CAS  Google Scholar 

  42. Kerrigan JR, Martha PM, Veldhuis JD, Blizzard RM, Rogol AD. Altered growth hormone secretory dynamics in prepubertal males with constitutional delay of growth. Pediatr Res 1993;33:278–83.

    Article  PubMed  CAS  Google Scholar 

  43. Schaefer F, Hamill G, Stanhope R, Preece MA, Scharesk, Cooperative Study Group on Pubertal Development in Chronic Renal Failure. Pulsatile growth hormone secretion in peripubertal patients with chronic renal failure. J Pediatr 1991;119:568–77.

    Article  PubMed  CAS  Google Scholar 

  44. Veldhuis JD, Blizzard RM, Rogol AD, Martha PM, Kirkland JL. Properties of spontaneous growth hormone bursts and half-life of endogenous growth hormone in boys with idiopathic short stature. J Clin Endocrinol Metab 1992;74:766–73.

    Article  Google Scholar 

  45. Oerter KE, Sobel AM, Rose SR, et al. Combining insulin-like growth factor-I and mean spontaneous nighttime growth hormone levels for the diagnosis of growth hormone deficiency. J Clin Endocrinol Metab 1992;75:1413–20.

    Article  PubMed  CAS  Google Scholar 

  46. Jorgensen EV, Shulman DI, Diamond FB, Root AW, Bercu BB. Spontaneous growth hormone secretion in children with normal and abnormal growth. In: Bercu BB, Walker RF, eds. Basic and clinical aspects of growth hormone II. New York: Springer-Verlag, 1994.

    Google Scholar 

  47. Schwartz ID, Hu CS, Shulman DI, Root AW, Bercu BB. Linear growth response to exogenous growth hormone in children with short stature. Am J Dis Child 1990;144:1092–7.

    PubMed  CAS  Google Scholar 

  48. Shulman DI, Hu CS, Root AW, Bercu BB. Pooled prolactin measurements in the evaluation of short children. J Clin Endocrinol Metab 1989;69:1261–7.

    Article  PubMed  CAS  Google Scholar 

  49. Chrousos GP, Poplack D, Brown T, O’Neill D, Schwade J, Bercu BB. Effects of cranial radiation on hypothalamic-adenohypophyseal function: abnormal growth hormone secretory dynamics. J Clin Endocrinol Metab 1982;53:1135–9.

    Article  Google Scholar 

  50. Blatt J, Bercu BB, Gillin JC, Mendelson WB, Poplack DG. Reduced pulsatile growth hormone secretion in children after therapy for acute lymphoblastic leukemia. J Pediatr 1984;104:182–6.

    Article  PubMed  CAS  Google Scholar 

  51. Jorgensen EV, Schwartz ID, Hivzdala E, et al. Neurotransmitter control of GH secretion in children after cranial radiation therapy. J Pediatr Endocrinol 1993;6:131–42.

    PubMed  CAS  Google Scholar 

  52. Martha PM, Reiter EO, Davila N, Shaw MA, Holcombe JH, Baumann G. The role of body mass in the response to growth hormone therapy. J Clin Endocrinol Metab 1992;75:1470–3.

    Article  PubMed  Google Scholar 

  53. Hopwood NJ, Hintz RL, Gertner JM, et al. Growth response of children with non-growth-hormone deficiency and marked short stature during three years of growth hormone therapy. J Pediatr 1993;123:215–22.

    Article  PubMed  CAS  Google Scholar 

  54. Moore WV, Moore KC, Gifford RG, Hollowell JG, Donaldson DL. Longterm treatment with growth hormone of children with short stature and normal growth hormone secretion. J Pediatr 1992;120:702–8.

    Article  PubMed  CAS  Google Scholar 

  55. Lippe BM, Nakamoto JM. Conventional and nonconventional uses of growth hormone. Recent Prog Horm Res 1993;48:1799–835.

    Google Scholar 

  56. Jorgensen JO. Human growth hormone replacement therapy: pharmacological and clinical aspects. Endocr Rev 1991;12:189–207.

    Article  PubMed  CAS  Google Scholar 

  57. Rosenfeld RG, Frane J, Attie KM, et al. Six-year results of a randomized prospective trial of human growth and oxandrolone in Turner syndrome. J Pediatr 1992;49:121–7.

    Google Scholar 

  58. Jorgensen JOL, Flyvbjerg A, Lauritzen T, Alberti KGMN, Orskov H, Christiansen JS. Dose-response studies with biosynthetic human growth hormone (GH) in GH-deficient patients. J Clin Endocrinol Metab 1988;67: 36–40.

    Article  PubMed  CAS  Google Scholar 

  59. Duck SC, Schwartz HP, Costlin G, et al. Subcutaneous growth hormone-releasing hormone therapy in growth hormone-deficient children: first year of therapy. J Clin Endocrinol Metab 1992;75:1115–20.

    Article  CAS  Google Scholar 

  60. Bowers CY, Alster KD, Frentz JM. The growth hormone-releasing activity of a synthetic hexapeptide in normal men and short statured children after oral administration. J Clin Endocrinol Metab 1992;74:292–8.

    Article  PubMed  CAS  Google Scholar 

  61. Bowers CY. GH-releasing peptides-structure and kinetics. J Pediatr Endocrinol 1993;6:21–31.

    Article  PubMed  CAS  Google Scholar 

  62. Smith RG, Cheng K, Schoen WR, et al. A nonpeptidyl growth hormone secretagogue. Science 1993;260:1640–3.

    Article  PubMed  CAS  Google Scholar 

  63. Cheng K, Chan WWS, Butler B, et al. Simulation of growth hormone release from rat primary pituitary cells by L-692,429, a novel non-peptidyl GH secretagogue [Abstract]. Int Symp Growth Hormone II: basic and clinical aspects, December, 1992:29.

    Google Scholar 

  64. Rivier J, Spiess J, Thorner M, Vale W. Characterization of a growth hormone releasing factor from human pancreatic islet tumor. Nature 1982; 300:276–8.

    Article  PubMed  CAS  Google Scholar 

  65. Guillemin R, Brazeau PE, Bohlen P, Esch F, Ling N, Wehrenberg WB. Growth hormone releasing factor from a human pancreatic tumor that caused acromegaly. Science 1982;218:585–7.

    Article  PubMed  CAS  Google Scholar 

  66. Ling N, Esch FS, Bohlen P, Brazeau PE, Wehrenberg WB, Guillemin R. Isolation, primary structure and synthesis of human hypothalamic somatrocrinin: growth hormone releasing factor. Proc Natl Acad Sci USA 1984;81:4302–6.

    Article  PubMed  CAS  Google Scholar 

  67. Butenandt O. Diagnostic value of growth hormone-releasing hormone tests in short children. Acta Paediatr Scand (Suppl) 1989;349:93–9.

    CAS  Google Scholar 

  68. Rosenthal SM, Schriock EA, Kaplan SL, Guillemin R, Grumbach MM. Synthetic human pancreatic growth hormone releasing factor (hpGRF1–44NH2) stimulates growth hormone secretion in normal men. J Clin Endocrinol Metab 1983;57:677–9.

    Article  PubMed  CAS  Google Scholar 

  69. Laron Z, Keret R, Bauman B, et al. Differential diagnosis between hypothalamic and pituitary hGH deficiency with the aid of synthetic GHRH 1–44. Clin Endocrinol 1984;21:9–12.

    Article  CAS  Google Scholar 

  70. Pertzelan A, Keret R, Bauman B, et al. Plasma growth hormone response to synthetic GH-RH 1–44 in 52 children and adults with growth hormone deficiency of various etiologies. Horm Res 1985;22:24–31.

    Article  PubMed  CAS  Google Scholar 

  71. Vance ML, Kaiser DK, Evans S, et al. Pulsatile growth hormone secretion in normal man during a continuous 24-hour infusion of human growth hormone releasing factor (1–40): evidence for intermittent somatostatin secretion. J Clin Invest 1985;75:1584–90.

    Article  PubMed  CAS  Google Scholar 

  72. Davies RR, Turner SJ, Orskov H, Johnston G. The interaction of human pancreatic growth hormone releasing factor 1–44 with somatostatin in vivo in normal man. Clin Endocrinol 1985;23:271–6.

    CAS  Google Scholar 

  73. Frohman LA. The role of hypothalamic hormones in the control of growth hormone secretion and of growth. Acta Paediatr Scand (Suppl) 1988;343:311.

    Google Scholar 

  74. Schriock EA, Hulse JA, Harris DA, Kaplan SLL, Grumbach MM. Evaluation of hypothalamic dysfunction in growth hormone (GH)-deficient patients using single versus multiple doses of GH-releasing hormone (GHRH-44) and evidence for diurnal variation in somatotroph responsiveness to GHRH in GH-deficient patients. J Clin Endocrinol Metab 1987;65:1177–82.

    Article  PubMed  CAS  Google Scholar 

  75. Davis JRE, Sheppard MC, Shakespear RA, Lynch SS, Clayton RN. Does growth hormone releasing factor desensitize the somatotroph? Interaction of responses of growth hormone during and after 10-hour infusion of GRF 1–29 amide in man. Clin Endocrinol 1986;24:135–40.

    Article  CAS  Google Scholar 

  76. Takano K, Hizuka N, Shizume K, et al. Plasma growth hormone (GH) response to GH-releasing factor in normal children with short stature and patients with pituitary dwarfism. J Clin Endocrinol Metab 1984;56: 236–41.

    Article  Google Scholar 

  77. Gelato MC, Malozoowski S, Caruso-Nicoletti M, et al. Growth hormone (GH) responses to GH-releasing hormone during pubertal development in normal boys and girls: comparison to idiopathic short stature and GH deficiency. J Clin Endocrinol Metab 1986;63:174–9.

    Article  PubMed  CAS  Google Scholar 

  78. Schriock EA, Lustig RH, Rosenthal SM, Kaplan SL, Grumbach MM. Effect of growth hormone (GH)-releasing hormone (GRH) on plasma GH in relation to magnitude and duration of GH deficiency in 26 children and adults with isolated GH deficiency or multiple pituitary hormone deficiency: evidence for hypothalamic GRH deficiency. J Clin Endocrinol Metab 1984; 58:1043–9.

    Article  PubMed  CAS  Google Scholar 

  79. Chalew SA, Armour KM, Livin PA, Thorner MO, Kowarski AA. Growth hormone (GH) response to GH-releasing hormone in children with subnormal integrated concentration of GH. J Clin Endocrinol Metab 1986; 62:1110–5.

    Article  PubMed  CAS  Google Scholar 

  80. Albini CH, Reiter EO, Mill BJ. Diagnostic value of the growth hormone-releasing factor stimulation test. Clin Pharmacol Ther 1988;43:696–700.

    Article  PubMed  CAS  Google Scholar 

  81. Thorner MO, Vance ML, Evans WS, et al. Clinical studies with GHRH in man. Horm Res 1986;24:91–7.

    Article  PubMed  CAS  Google Scholar 

  82. Clark RG, Robinson ICAF. Growth hormone response to multiple injections of a fragment of human growth hormone-releasing factor in conscious male and female rats. J Endocrinol 1985;106:218–89.

    Google Scholar 

  83. Chatelain P, Alamercery Y, Blanchard J, et al. Growth hormone (GH) response to a single intravenous injection of synthetic GH-releasing hormone in prepubertal children with growth failure. J Clin Endocrinol Metab 1987;65: 387–94.

    Article  PubMed  CAS  Google Scholar 

  84. Tannenbaum GS, Ling N. The interrelationship of growth hormone (GH)-releasing factor and somatostatin in generation of the ultradian rhythm of GH secretion. Endocrinology 1984;115:1952–7.

    Article  PubMed  CAS  Google Scholar 

  85. Tannenbaum GA. Somatostatin as a physiological regulator of pulsatile growth hormone secretion. Horm Res 1988;29:70–4.

    Article  PubMed  CAS  Google Scholar 

  86. Martha PM, Blizzard RM, McDonald JA. A persistent pattern of varying pituitary responsivity to exogenous growth hormone (GH)-releasing hormone in GH-deficient children: evidence supporting periodic somatostatin secretion. J Clin Endocrinol Metab 1988;67:449–54.

    Article  PubMed  CAS  Google Scholar 

  87. Tannenbaum GS, Painson JC, Lengyel MJ, Brazeau P. Paradoxical enhancement of pituitary growth hormone (GH) responsiveness to GH-releasing factor in the face of high somatostatin tone. Endocrinology 1989;124:1380–8.

    Article  PubMed  CAS  Google Scholar 

  88. Codd EE, Shu AYL, Walker RF. Binding of a growth hormone releasing hexapeptide to specific hypothalamic and pituitary binding sites. Neuropharmacology 1989;28:1139–44.

    Article  PubMed  CAS  Google Scholar 

  89. Blake AD, Smith RG. Desensitization studies using perfused pituitary cells show that growth hormone-releasing hormone and His-D-Trp-Ala-Trp-DPhe-Lys-NH2 stimulate growth hormone release through distinct receptor sites. J Endocrinol 1991;129:11–9.

    Article  PubMed  CAS  Google Scholar 

  90. Cheng K, Chan WW-S, Barreta A, Convey DM, Smith RG. The synergistic effects of HIS-D-TRP-ALA-TRP-D-PHE-LYS-NH2 on growth hormone (GH)-releasing factor-stimulated GH release and intracellular adenosine 3,5’monophosphate accumulation rat primary pituitary cell culture. Endocrinology 1991;124:11–9.

    Google Scholar 

  91. Bowers CY, Reynolds GA, Durham D, Barrera CM, Pezzoli SS, Thorner MO. Growth hormone (GH)-releasing peptide stimulates GH release in normal men and acts synergistically with GH-releasing hormone. J Clin Endocrinol Metab 70:975–82.

    Article  Google Scholar 

  92. Bercu BB, Yang S-W, Masuda R, Walker RF. Role of selected endogenous peptide in growth hormone releasing hexapeptide (GHRP-6) activity: analysis of GHRH, TRH and GNRH. Endocrinology 1992;130:2579–86.

    Article  PubMed  CAS  Google Scholar 

  93. Walker RF, Yang S-W, Bercu BB. Robust GH secretion in aging female rats coadministered growth hormone releasing hormone (GHRH) and GH releasing hexapeptide (GHRP-6). Life Sci 1991;49:1499–504.

    Article  PubMed  CAS  Google Scholar 

  94. Bercu BB, Yang S-W, Masuda R, HU C-S, Walker RF. Structural and functional responses of aged female rats to chronic co-administration of growth hormone releasing hormone (GHRH) and GH releasing hexapeptide (GHRP-6) [Abstract]. Annu meet Endocr Soc, San Antonio, TX, 1992.

    Google Scholar 

  95. Bercu BB, Walker RF. Rodent models for anaylsis of growth hormone secretory deficits [Abstract]. Society for Pediatric Research, Washington, DC, 1993.

    Google Scholar 

  96. Lantos J, Siegler M, Cuttler L. Ethical issues in growth hormone therapy. JAMA 1989;216:1020–4.

    Article  Google Scholar 

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Bercu, B.B., Heinze, H.J., Walker, R.F. (1995). Use of Growth Hormone in Non-Growth-Hormone-Deficient Children: Physiologic, Pharmacologic, and Ethical Issues. In: Blackman, M.R., Roth, J., Harman, S.M., Shapiro, J.R. (eds) GHRH, GH, and IGF-I. Serono Symposia USA. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-0807-5_14

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