Abstract
GH release is abnormally regulated in insulin-dependent diabetes (IDDM). Paradoxical stimulation of GH after TRH and an association with retinopathy has been reported in young adults. However, overnight secretion of GH is also increased in IDDM, and it may be difficult to distinguish spontaneous release from that seen after TRH. To resolve this question we carried out TRH and saline control studies following overnight GH profiles in 6 adolescents with IDDM.
4 boys and 2 girls (age 11.4-14.7 y; pubertal stage 2-4: duration IDDM 2.4-6.7 y; HbA1C 8.4-11.5%) had 2 GH profiles (15 min aliquots by continuous sampling from 20.00-08.00 hrs) 4-6 wks apart. At 08.10 hrs TRH (200 mcg) or saline (1ml 0.9%) were given IV. Samples were taken at -10, 0, 10, 20, 30, 10, 60 and 90 min Tor GH.
A rise in GH was seen in 4 of 6 following TRH, but with no consistent pattern, the peak occurring at any time between 10 and 90 min. A rise was also seen in 5 of 6 following saline. Mean blood glucose was identical during TRH and saline tests (9.5 ± 1.6 vs 7.5 ± 0.6 mmol/l, x ± SEM, p = 0.35). Peak GH levels were similar (19.3 ± 4.4 vs 25.8 ± 5.5 mU/l) after TRH and saline (p = 0.4), as were mean GH and areas under GH curve. The timing of the GH peak after both TRH and saline could be predicted from the overnight secretory profile.
Paradoxical GH rise following TRH is not seen in adolescents with IDDM. Previous reports of GH release after TRH may have been due to timing coincident with a normal GH pulse.
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Edge, J., Human, D. & Dunger, D. 45 OVERNIGHT GROWTH HORMONE (GH) RELEASE AND GH RESPONSE TO TRH IN ADOLESCENT DIABETES. Pediatr Res 24, 524 (1988). https://doi.org/10.1203/00006450-198810000-00066
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DOI: https://doi.org/10.1203/00006450-198810000-00066