Skip to main content
SpringerLink
Log in

Glucocorticosteroids and growth hormone secretion under physiological conditions and in states of steroid excess

  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Cortisol and growth hormone (GH) secretion (spontaneous variations at night and the release induced by insulin hypoglycaemia) were investigated in 69 children and adolescents. Statistical analysis of approximately 600 pairs of cortisol and GH values in this study demonstrated that physiological fluctuations of cortisol do not alter GH secretion.

A review of the literature shows that GH secretion is consistently depressed in Cushing's disease of central origin and in Cushing's syndrome due to adrenal carcinoma. When acutely administered, doses higher than 100 mg of cortisol (or equivalent amounts of other steroids) per adult are necessary to block GH secretion and the hormones have to be given several hours previously. In long-term steroid treatment, suppression of GH is observed in only 1 out of 3 patients. The effect apparently does not persist beyond elimination of the last dose, i.e. generally not longer than 12 to 24 h. These data can be taken as a rationale for intermittent or alternating dosage schedules, and for the use of short acting derivatives if long-term, high-dose steroid treatment is necessary in children.

It remains to be established whether growth deficiency in exogenous hypercortisolism is due to suppression of GH secretion, decreased production of somatomedins, direct antagonism of the action of somatomedins on growing cartilage, or a combination of these mechanisms.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Butenandt, O., Kelch, A., Rajman, E.: Growth hormone studies in patients with rheumatoid arthritis with or without glucocorticoid therapy. Z. Kinderheilk. 118, 53–62 (1974)

    Google Scholar 

  2. Cacciari, E., Cicognani, A., Pirazzoli, P., Tassoni, P., Zappulla, F., Salardi, S., Bernardi, F.: Relationships among the secretion of ACTH, GH, and cortisol during the insulin-induced hypoglycemia test in the normal and obese child. J. Clin. Endocr. 40, 802–806 (1975)

    Google Scholar 

  3. Demura, R., Demura, H., Nunokawa, T., Baba, H., Miura, K.: Responses of plasma ACTH, GH, LH and 11 hydroxycorticosteroids in patients with Cushing's syndrome. J. Clin. Endocr. 34, 852–859 (1972)

    Google Scholar 

  4. Elders, M. J., Wingfield, B. S., McNatt, M. L., Clarke, J. S., Hughes, E. R.: Glucocorticoid therapy in children. Effect on somatomedin secretion. Am. J. Dis. Child. 129, 1393–1396 (1975)

    Google Scholar 

  5. Frantz, A. G., Rabkin, M. T.: Human growth hormone. Clinical measurement, response to hypoglycemia and suppression by corticosteroids. New Engl. J. Med. 271, 1375–1381 (1964)

    Google Scholar 

  6. Gács, G., Kun, E., Czirbesz, Z.: Growth hormone secretion in children during corticosteroid treatment. Responses to arginine. Horm. Metab. Res. 5, 106–108 (1973)

    Google Scholar 

  7. Hanssen, K. F., Asfeldt, V. H.: Human growth hormone secretion during major surgical stress and the influence of pre-treatment with dexamethasone. Horm. Metab. Res. 4, 57 (1972)

    Google Scholar 

  8. Hashimoto, K.: The pituitary ACTH, GH, LH, FSH, TSH and prolactin reserves in patients with Cushing's syndrome. Endocr. Japon. 22, 67–77 (1975)

    Google Scholar 

  9. Hartog, M., Gaafar, M. A., Fraser, R.: Effect of corticosteroids on serum growth hormone. Lancet 1964 II, 376–378

    Google Scholar 

  10. James, V. H., Landon, J., Wynn, V., Greenwood, F. C.: A fundamental defect of adrenocortical control in Cushing's disease. J. Endocrinol. 40, 15–28 (1968)

    Google Scholar 

  11. Komatsu, F.: Growth hormone secretion in children. Part I.: The effect of corticosteroids on the growth hormone secretion with insulin induced hypoglycemia. Acta Paed. Jap. 15, 27–38 (1973)

    Google Scholar 

  12. Krieger, D. T., Albin, J., Paget, S., Glick, S. M.: Failure of suppression of nocturnal growth hormone rise by acute corticosteroid administration. Horm. Metab. Res. 4, 463–466 (1972)

    Google Scholar 

  13. Krieger, D. T., Glick, S. M.: Sleep EEG stages and plasma growth hormone concentration in states of endogenous and exogenous hypercortisolemia or ACTH elevation. J. Clin. Endocr. 39, 986–1001 (1974)

    Google Scholar 

  14. Martin, M. M., Gaboardi, F., Podolsky, S., Raiti, S., Calcagno, P. L.: Intermittent steroid therapy. Its effect on hypothalamic-pituitary-adrenal function and the response of plasma growth hormone and insulin to stimulation. New Engl. J. Med. 279, 273–278 (1968)

    Google Scholar 

  15. Miller, M., Moses, A. M.: Effect of temperature and dexamethasone on the plasma 17-hydroxycorticoid and growth hormone responses to pyrogen. J. Clin. Endocr. 28, 1056–1063 (1968)

    Google Scholar 

  16. Miura, K., Aida, M., Mihara, A., Katsuhiko, K., Ojima, M., Demura, R., Demura, H., Okuyama, M.: Treatment of Cushing's disease with reserpine and pituitary irradiation. J. Clin. Endocr. 41, 511–526 (1975)

    Google Scholar 

  17. Morris, H. G., Jorgensen, J. R., Jenkins, S. A.: Plasma growth hormone concentration in corticosteroid treated children. J. Clin. Invest. 47, 427–435 (1968)

    Google Scholar 

  18. Morrow, L. B., Mellinger, R. C., Prendergast, J. J., Guansing, A. R.: Growth hormone in hypersecretory diseases of the adrenal gland. J. Clin. Endocr. 29, 1364–1368 (1969)

    Google Scholar 

  19. v. Mühlendahl, K. E., Gadner, H., Riehm, H., Helge, H., Weber, B., Müller-Hess, R.: Endocrine function after antineoplastic therapy in 22 children with acute lymphoblastic leukaemia. Helv. Paed. Acta 31, 463–471 (1976)

    Google Scholar 

  20. Nakagawa, K., Horiuchi, Y., Mashimo, K.: Responses of plasma growth hormone and corticosteroids to insulin and arginine with or without prior administration of dexamethasone. J. Clin. Endocr. 29, 35–40 (1969)

    Google Scholar 

  21. Nakagawa, K., Horiuchi, Y., Mashimo, K.: Effect of dexamethasone on plasma growth hormone levels in acromegaly. J. Clin. Endocr. 31, 502–506 (1970)

    Google Scholar 

  22. Nakagawa, K., Mashimo, K.: Suppression of exercise-induced growth hormone release with dexamethasone. Horm. Metab. Res. 5, 225–226 (1973)

    Google Scholar 

  23. Neri, V., Bartorelli, A., Ambrosi, B., Peccoz, P. B., Faglia, G.: Effect of corticotrophin on plasma-growth-hormone. Lancet 1970 I, 1287

  24. Pantelakis, S. N., Sinaniotis, C. A., Sbirakis, S., Ikkos, D., Doxiadis, S. A.: Night and day growth hormone levels during treatment with corticosteroids and corticotrophin. Arch. Dis. Childh. 47, 605–608 (1972)

    Google Scholar 

  25. Phillips, L. S., Herington, A. C., Daughaday, W. H.: Hormone effects on somatomedin action and somatomedin generation. In: Advances in Human Growth Hormone (ed. S. Raiti), pp. 50–67. DHEW No. (NIH) 74-612, Washington, 1973

  26. Quabbe, H. J.: Radioimmunologische Bestimmung von Wachstumshormon im Plasma des Menschen. Z. Klin. Chem. 7, 259–268 (1969)

    Google Scholar 

  27. Rabinowitz, D., Merimee, T. J., Nelson, J. K.: The hormonal profile in obesity. Trans. Ass. Amer. Physicians 80, 190–199 (1967)

    Google Scholar 

  28. Rabinowitz, D., Merimee, T. J., Nelson, J. K., Schultz, R. B., Burgess, J. A.: The influence of proteins and amino acids on growth hormone release in man. In: Growth and Growth Hormone (eds. A. Pecile, E. E. Müller), pp. 105–115. Amsterdam: Excerpta Medica 1968

    Google Scholar 

  29. Root, A. W., Rosenfield, R. L., Bongiovanni, A. M., Eberlein, W. R.: The plasma growth hormone response to insulin-induced hypoglycemia in children with retardation of growth. Pediatrics 39, 844–852 (1967)

    Google Scholar 

  30. Root, A. W., Bongiovanni, A. M., Eberlein, W. R.: Studies of the secretion and metabolic effects of human growth hormone in children with glucocorticoid-induced growth retardation. J. Pediat. 75, 826–832 (1969)

    Google Scholar 

  31. Sadeghi-Nejad, A., Senior, B.: Adrenal function, growth, and insulin in patients treated with corticoids on alternate days. Pediatrics 43, 277–283 (1969)

    Google Scholar 

  32. Sanders, S. S., Norman, A. P.: Growth hormone secretion in growth-retarded children. Brit. Med. J. 1969 III, 25–26

    Google Scholar 

  33. Stempfel, R. S., Sheikholislam, B. M., Lebovitz, H. E., Allen, E., Franks, R. C.: Pituitary growth hormone suppression with low-dosage, longacting corticoid administration. J. Pediat. 73, 767–773 (1968)

    Google Scholar 

  34. Stiel, J. N., Island, D. P., Liddle, G. W.: Effect of glucocorticoids on plasma growth hormone in man. Metabolism 19, 158–164 (1970)

    Google Scholar 

  35. Strauch, G., Modigliani, E., Luton, J. P., Bricaire, H.: Partial somatotrophin insufficiency in Cushing's syndrome. Acta Endocr. (Kbh.) 60, 121–129 (1969)

    Google Scholar 

  36. Sturge, R. A., Beardwell, C., Hartog, M., Wright, D., Ansell, B. M.: Cortisol and growth hormone secretion in relation to linear growth: Patients with Still's disease on different therapeutic regimens. Brit. Med. J. 1970 III, 547–551

    Google Scholar 

  37. Takahashi, Y., Kipnis, D. M., Daughaday, W. H.: Growth hormone secretion during sleep. J. Clin. Invest. 47, 2079–2090 (1968)

    Google Scholar 

  38. Thompson, R. G., Rodriguez, A., Kowarski, A., Blizzard, R. M.: Growth hormone: metabolic clearance rates, integrated concentrations, and production rates in normal adults and the effect of prednisone. J. Clin. Invest. 51, 3193–3198 (1972)

    Google Scholar 

  39. Vasquez, A. M., Schutt-Aine, J., Drash, A. L., Kenny, F. M.: Diurnal patterns of secretion of cortisol and growth hormone in patients with exogenous and endogenous Cushing's syndrome, in patients with diabetes mellitus, and in a fasting subject. J. Pediat. 83, 578–586 (1973)

    Google Scholar 

  40. Vescei, P., Penke, B., Katzy, R., Baek, L.: Radioimmunological determination of plasma cortisol. Experientia (Basel) 28, 1104–1105 (1971)

    Google Scholar 

  41. von Werder, K., Hane, S., Forsham, P. H.: Suppression of the hypothalamo-pituitary-adrenal axis and growth hormone release with dexamethasone. Horm. Metab. Res. 3, 171–174 (1971)

    Google Scholar 

  42. Westphal, O.: Human growth hormone. Acta Paediat. Scand. Suppl. 182 (1968)

Download references

Author information

Authors and Affiliations

  1. Universitäts-Kinderklinik, Freie Universität, Heubnerweg 6, D-1000, Berlin

    K. E. v. Mühlendahl, B. Weber, R. Müller-Hess, S. Korth-Schütz & H. Helge

Authors
  1. K. E. v. Mühlendahl
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. B. Weber
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. Müller-Hess
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. Korth-Schütz
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. H. Helge
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Dedicated to Professor H. Bickel on the occasion of his 60th birthday

Supported by Deutsche Forschungsgemeinschaft (Mu 254/5)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mühlendahl, K.E.v., Weber, B., Müller-Hess, R. et al. Glucocorticosteroids and growth hormone secretion under physiological conditions and in states of steroid excess. Eur J Pediatr 128, 113–121 (1978). https://doi.org/10.1007/BF00496996

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00496996

Key words

Search

Navigation