Abstract
A 13½-year-old prepubertal Mexican boy with features of growth hormone (GH) deficiency had elevated fasting GH (5.7-66 ng/ml). Serum somatomedin (Sm) activity (sulfation factor) was low 0.3 U/ml (normal > 0.3 U/ml). Sm activity remained low (0.16-0.25 U/ml) during and following HGH, 5 IU daily for 5 days. GH levels increased following insulin-induced hypoglycemia (IH) and L-dopa but not after arginine. Chlorpromazine suppressed fasting GH to <0.8 ng/ml but did not suppress GH release following IH. Dexamethasone did not suppress fasting GH or GH response to IH. Before HGH an oral glucose tolerance test (OGTT) was abnormal with a peak plasma IRI of 21 μU/ml. Plasma testosterone (T) was 85 ng/100 ml. After 3 months of HGH (12 IU/week) the OGTT was normal and peak IRI 37 μU/ml; Sm was 0.22 U/ml and height increase (Δht)1.9 cm. After 6 months of HGH, peak IRI during OGTT was 74 μU/ml; Sm, 0.19-0.26 U/ml; plasma T, 425 ng/100 ml; and Δht, 3.8 cm. After 8½ months of HGH peak IRI was 69 μU/ml during OGTT; plasma T, 722 ng/100 ml; and total Δht, 6.3 cm.
These data suggest that: a) growth was not mediated by circulating Sm but may have been due in part to insulin and perhaps HGH itself in addition to T; b) HGH had a direct affect on the pancreatic β-cell not mediated by circulating Sm; and c) the hypothalamic GH releasing hormone receptor was partially intact.
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Clemons, R., Costin, G. & Kogut, M. LARON'S DWARFISM: GROWTH AND IMMUNOREACTIVE INSULIN (IRI) FOLLOWING HUMAN GROWTH HORMONE (HGH). Pediatr Res 8, 367 (1974). https://doi.org/10.1203/00006450-197404000-00165
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DOI: https://doi.org/10.1203/00006450-197404000-00165