Growth Hormone (GH) Profiles with Successive Provocation by GH-releasing Hormone and Arginine in Children: A Clinical Appraisal.
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- SATO TAMOTU
- Department of Pediatrics, School of Medicine, Kanazawa University
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- IGARASHI NOBORU
- Department of Pediatrics, School of Medicine, Kanazawa University
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- MIYAGAWA KAZUHIKO
- Department of Pediatrics, School of Medicine, Kanazawa University
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- SHIMIZU MAKOTO
- Department of Pediatrics, School of Medicine, Kanazawa University
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- NISHIKAWA TAKESHI
- Department of Pediatrics, School of Medicine, Kanazawa University
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抄録
To establish a single and reliable test for evaluating growth hormone (GH) secretion, we examined successive GH provocation by two agents with different modes of action, GH releasinghormone (GHRH) and arginine (Arg) in 60 children of short stature, 6 patients with pituitary dwarfism and 9 normal young adults. Their GH profiles were qualitatively classified into 4 types: 25 children and 7 adults responded to both stimuli with 2 GH peaks (48.7±4.3 [SEM]μg/L for GHRH and 32.2±2.6μg/L for Arg in Children; 25.8±7.6μg/L and 30.1±9.2μg/L respectively in adults)(type A). A Single peak tor GHRH (57.7±4.6μg/L) without an Arg-induced peak was obtained in 29 younger children (type B), which is considered to be a GHRH-dominant pattern. Two of them were diagnosed as hypothalamic GHRH deficiency based on a low nocturnal plasma GH and good response to GH treatment. Six adolescents and 2 adults showed a blunted response to GHRH (9.0±1.1μg/L) but a normal response to Arg (40.6±9.5μg/L)(type C), which appears to be caused by somatostatin (SRIH) hypertonicity. None with pituitary dwarfism responded to both stimuli (4.5±1.3 and 2.3±0.5μg/L). Thus, the GHRH-Arg test makes it possible to evaluate the counterbalance between GHRH and SRIH as well as to differentiate pituitary GH deficiency from hypothalamic GHRH dysfunction.
収録刊行物
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- Endocrinologia Japonica
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Endocrinologia Japonica 38 (1), 33-38, 1991
一般社団法人 日本内分泌学会