Abstract
We experienced a 41-year-old acromegalic male (Case 1) in whom the basal plasma GH was extremely high (320–450 ng/mL) but plasma IGF-I was only slightly elevated (2.0–2.8 U/mL). His nutritional condition and associated diabetes mellitus did not appear to be responsible for the relatively low IGF-I level, and a GH-autoantibody in the plasma was absent. We thus performed gel filtration analyses of his plasma and somatotroph adenoma to determine elution patterns of immunoreactive (IR) and receptor active (RA) GH. For comparison, the same studies were carried out on plasmas and somatotroph adenomas obtained from three other acromegalics (Cases 2-4) whose basal plasma GH and IGF-I levels were 22-45 ng/mL and 3.5–6.0 U/mL, respectively. IR GH in Case 1’s plasma distributed over an extremely wide range keeping similar titers rather than showing three discernible components (big-big, big, and little GH) as did plasmas and adenomas from Cases 2–4. And, most of the IR GH in Case 1’s plasma was eluted in such fractions that contained low levels of RA GH, indicating a minor proportion of biologically active GH. However, interestingly, the chromatographic profile and total GH content of Case 1’s adenoma were similar to those of Cases 2-4’s adenomas. These results may, at least in part, explain the discrepancy between the plasma GH and IGF-I levels of Case 1. The unexpectedly different GH elution patterns between the plasma and adenoma from this patient, may suggest a contribution of certain plasma factor(s) to the un-usual chromatographic profile of plasma GH.
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References
Molitch M.E. Acromegaly. In: Collu R., Brown G.M., Van Loon G.R. (Eds.), Clinical Neuroendocrinology, ed. 2. Blackwell, Boston, 1988
Clemmons D.R., Van Wyk J.J., Ridgway EC, Kliman B., Kjellberg R.N., Underwood L.E. Evaluation of acromegaly by radioimmunoassay of somatomedin-C. N. Engl. J. Med. 301:1138, 1979.
Gorden P., Lesniak M.A., Hendricks CM., Roth J. “Big” growth hormone components from human plasma: decreased reactivity demonstrated by ra dioreceptor assay. Science 182:829, 1973.
Herington A.C., Jacobs L.S., Daughaday W.H. Radioreceptor and radioimmunoassay quantitation of human growth hormone in acromegalic serum: overestimation by immunoassay and systemic differences between antisera. J. Clin. Endocrinol. Metab. 39:257, 1974.
Moses A.C., Molitch M.E., Sawin C.T., Jackson I.M.D., Biller B.J., Furlanetto R., Reichlin S. Bromocriptine therapy in acromegaly: use in patients resistant to conventional therapy and effects on serum levels of somatomedin-C. J. Clin. Endocrinol. Metab. 53:752, 1981.
Tanaka T., Aiba T., Shishiba Y. Discrepancy between immunoactivity and bioactivity of big-big and big human growth hormone in acromegaly. Endocrinol. Jpn. 31:133, 1984.
Oppizzi G., Petroncini M.M., Dallabozana D., Cozzi R., Verde G., Chiodini P.G., Liuzzi A. Relationship between somatomedin-C and growth hormone levels in acromegaly: basal and dynamic evaluation. J. Clin. Endocrinol. Metab. 63:1348, 1986.
Tan K., Baxter R.C. Serum insulin-like growth factor I levels in adult diabetic patients: the effect of age. J. Clin. Endocrinol. Metab. 63:651, 1986.
Blethen S.L, Sargeant D.T., Whitlow M.G., Santiago J.V. Effect of pubertal stage and recent blood glucose control on plasma somatomedin-C in children with insulin-dependent diabetes mellitus. Diabetes 30:868, 1981.
Goodman A.D., Tanenbaum R., Rabinowitz D. Existence of two forms of immunoreactive growth hormone in human plasma. J. Clin. Endocrinol. Metab. 35:868, 1972.
Tsushima T., Friesen H.G. Radioreceptor assay for growth hormone. J. Clin. Endocrinol. Metab. 37:334, 1973.
Suda T., Demura H., Demura R., Jibiki K., Tozawa F., Shizume K. Anterior pituitary hormones in plasma and pituitaries from patients with Cushing’s disease. J. Clin. Endocrinol. Metab. 51:1048, 1980.
Horner J.M., Kemp S.F., Hintz R.L. Growth hormone and somatomedin in insulin-dependent diabetes mellitus. J. Clin. Endocrinol. Metab. 53:1148, 1981.
Merimee T.J., Zapf J., Froesch E.R. Insulin-like growth factors: studies in diabetes with and without retinopathy. N. Engl. J. Med. 309: 527, 1983.
Baumann G., MacCart J.G. Growth hormone production by human pituitary glands in organ culture: evidence for predominant secretion of the single-chain 22,000 molecular weight form (Isohormone B). J. Clin. Endocrinol. Metab. 55:611, 1982.
Herington A.C., Ymer S., Stevenson J. Identification and characterization of specific binding protein for growth hormone in normal human sera. J. Clin. Invest. 77:1817, 1986.
Baumann G., Stolar M.W., Arnberun K., Barsano C.P., DeVries B.C. A specific growth hormone-binding protein in human plasma: initial characterization. J. Clin. Endocrinol. Metab. 62:134, 1986.
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Watanobe, H., Ishii, M., Kudo, T. et al. A marked molecular heterogeneity of growth hormone (GH) detected in the plasma but not pituitary of a patient with acromegaly: Comparison with other acromegalics and an implication for discrepant plasma levels of GH and insulin-like growth factor I. J Endocrinol Invest 15, 381–386 (1992). https://doi.org/10.1007/BF03348758
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DOI: https://doi.org/10.1007/BF03348758