Abstract
We investigated the possibility of inducing a physiological GH pattern by exogenous administration of GRF 1-44 in a pulsatile manner in order to modify the condition resulting from a hypothalamic defect. Three adolescent patients with short stature and four normal men responded to a pulsatile i.v.-administration of GRF 1-44 with a clear increase in the GH levels. No patient was on GH therapy at the time of the study. After a 12 hour nocturnal plasma profile of GH, cortisol, PRL and glucose (blood samples every 20 min) all subjects received 50 μg GRF 1-44 i.v. at 8 and 10 a.m. and every second hour for 12 hours during the following night. Blood samples were taken every 20min to evaluate pituitary response. Results: Patient 1 did not show any spontaneous nocturnal GH pulses but responded to pulsatile GRF stimulation with GH levels of 1.5 to 6.7 ng/ml in the morning and from 3.0 to 15.8 ng/ml at night, thus proving hypothalamic GRF deficiency. Patients 2 and 3 both had 4-5 spontaneous nocturnal GH peaks ranging from 8-40 ng/ml. GH responses to pulsatile GRF were between 10.4 and 109 ng/ml at morning and between 12.3 and 114 ng/ml during the night. The characteristic circadian plasma profiles of cortisol, PRL and glucose remained intact. In the volunteers, spontaneous nocturnal GH peaks ranged from 5.8-17.5 ng/ml, whereas GH responses to pulsatile GRF peaked at 9.1-54 ng/ml in the morning and at 20-73 ng/ml during the night. Conclusions: Our preliminary results suggest (1) that pituitary sensitivity to exogenous pulsatile GRF is markedly higher during the night than in the morning and (2) that a normal circadian GH pattern can be induced in GRF deficient patients by pulsatile GRF.
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Hümmelink, R., Meijer, U., Boucher, M. et al. Pulsatile administration of GRF 1–44 to male patients with Growth-hormone-deficiency and normal men. Pediatr Res 18, 1210 (1984). https://doi.org/10.1203/00006450-198411000-00059
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DOI: https://doi.org/10.1203/00006450-198411000-00059