Abstract
In order to evaluate if the assessment of the paradoxical GH responses to TRH in diabetic subjects could be altered by the presence of spontaneous fluctuations in plasma GH levels, we compared GH responses to TRH and to saline injection in 19 insulin-dependent diabetic patients. We observed significant increments (> 5 ng/ml) in plasma GH levels after TRH iv administration in 5 of 19 patients (26%); on the other hand, a significant increase was also observed in 6 patients (31%) after saline. We conclude that, at least in some diabetics, spontaneous GH pulses might be misinterpreted as paradoxical GH responses after a nonspecific stimulus administration. Moreover, the real existence of the paradoxical GH response to TRH has to be assessed using the following strict criteria: a sufficient magnitude in GH increment (> 5 ng/ml), the comparison of the kinetics of GH secretion after TRH and saline in the same patient, the presence of a significant GH rise above basal levels within the first 30 min after TRH injection.
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Gerich J.E. Role of growth hormone in diabetes mellitus. N. Engl. J. Med. 310: 848, 1984.
Lundbaek K., Christensen N.J., Jensen V.A., Johansen K., Olsen T.S, Ørskov A.P., Østerby R. Diabetes, diabetic angiopathy and growth hormone. Lancet 2: 131, 1970.
Barnes A.J., Kohner E.M., Johnston D.G., Alberti K.G.M.M. Severe retinopathy and mild carbohydrate intolerance: possible role of insulin deficiency and elevated circulating growth hormone. Lancet 1: 1465, 1985.
Hayford J.T., Danney M.M., Hendrix J.A., Thompson R.G. Integrated concentration of growth hormone in juvenile-onset diabetes. Diabetes 29: 391, 1980.
Cremer G.M., Molnar G.D., Taylor W.F., Rosevear J.W., Ackerman E. Growth hormone release in unstable diabetes. Test with saline, arginine, glucagon and epinephrine. Acta Diabetol. Lat. 10: 1216, 1973.
Dasmahapatra A., Urdanivia E., Cohen M.P. Growth hormone response to thyrotropin releasing hormone in diabetes. J. Clin. Endocrinol. Metab. 52: 859, 1981.
Ceda G.P., Speroni G., Dall’Aglio E., Valenti G., Butturini U. Nonspecific growth hormone response to thyrotropin releasing hormone in insulin dependent diabetes: Sex and age related pituitary responsiveness. J. Clin. Endocrinol. Metab. 55: 170, 1982.
Chiodera P., Coiro V., Speroni G., Capretti L., Muzzetto P., Volpi R., Butturini U. The growth hormone response to thyrotropin releasing hormone in insulin dependent diabetics involves a cholinergic mechanism. J. Clin. Endocrinol. Metab. 59: 794, 1982.
Vanelli M., Bernasconi S., Bolondi O., Mami C., Pandullo E., Scaffidi M., Siracusano M.F., De Luca F. Effects of intravenous TRH on growth hormone and cortisol serum levels in children and adolescents with insulin dependent diabetes mellitus. J. Endocrinol. Invest. 9: 293, 1986.
Winkler G., Gero L., Haimos T., Grosz A., Gefferth G., Ga P., Tamas G. Jr. Arginine induced growth hormone (hGH) response and paradoxical hGH secretion stimulated by TRH in diabetes mellitus. Acta Diabetol. Lat. 24: 109, 1987.
Molnar G.D., Taylor W.F., Langworthy A., Fatourechi V. Diurnal growth hormone and glucose abnormalities in unstable diabetics: Studies of ambulatory-fed subjects during continuous blood glucose analysis. J. Clin. Endocrinol. Metab. 34: 837, 1972.
Le Dafniet M., Gamier P., Brandi A.M., Bression D., Scherrer H., Racadot J., Peillon F. Interaction between somatostatin and TRH on growth hormone secretion in perifused human growth hormone tumor cells. Horm. Res. 21: 235, 1985.
Dieguez C., Page M.D., Scanion M.F. Growth hormone neuroregulation and its alterations in disease states. Clin. Endocrinol. (Oxf.) 28: 109, 1988.
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Valentini, U., Cimino, A., Rotondi, A. et al. Growth hormone response to thyrotropin releasing hormone and placebo in a group of insulin dependent diabetic patients. J Endocrinol Invest 12, 643–646 (1989). https://doi.org/10.1007/BF03350025
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DOI: https://doi.org/10.1007/BF03350025