Abstract
GH replacement therapy (Rx) causes rapid skeletal growth, some suggest by GH-dependent 25-OH D 1-hydroxylase activation. We studied 12 GH deficient children before and for 1 wk after high dose (5IU/da) Rx, and at 1 mo, 3 mo and 1 y after conventional (0.1 IU/kg × 3/wk) Rx. Unstimulated (Uns) ionized calcium (Ca) did not change. Likewise, Uns PTH (1-84, N<57μ1Eq/ml) did not vary from 38.9 ± 2.6 before Rx (all are mean ± SEM). 24-h urinary cyclic AMP excretion corrected for volume of glomerular filtrate (GF) (UcAMP) did not change within 1 wk (2.99 ± 0.20 nmole/ dl GF, 3.15 ± 0.24 after), but had risen by 3 mo to 4.51 ± 0.70 (p<0.05) and by 1 y to 6.64 ± 1.50 (p<0.02). Uns calcitonin (CT) (1-32, N<107 pg/ml) fell from 29.4 ± 2.8 before to 21.5 ± 1.8 after (p< 0.05), but was not different from preRx by 1 y (43.4 ± 11.0). In 6 of the children, 1,25-diOH D rose from 31.1 ± 1.9 pg/ml to 45.8 ± 4.0 (p<0.001) during the first week following inception. By 1 mo, 1,25-diOH D had fallen to 43.0 ± 7.1 (p<0.02) and by 3 mo was no longer different from basal. In summary 1) GH Rx induced a rapid rise in 1,25-diOH D, which fell again by 3 mo. 2) Uns CT fell immediately after Rx, but was no different from initial by 1 y. 3) Although Uns Ca and PTH did not vary, 4) UcAMP rose progressively. Conclusion: GH activates the 1-hydroxylase during early Rx and sensitizes the kidney to parathormone by 3 mo.
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Burstein, S., Chen, I., Hug, G. et al. Growth Hormone Causes a Rise in 1,25-diOH D and Sensitizes the Kidney to Parathormone. Pediatr Res 15, 1542 (1981). https://doi.org/10.1203/00006450-198112000-00042
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DOI: https://doi.org/10.1203/00006450-198112000-00042