Prolactin deficiency is independently associated with reduced insulin-like growth factor I status in severely growth hormone-deficient adults.

2.50
Hdl Handle:
http://hdl.handle.net/10541/72418
Title:
Prolactin deficiency is independently associated with reduced insulin-like growth factor I status in severely growth hormone-deficient adults.
Authors:
Mukherjee, Annice; Ryder, W David J; Jöstel, Andreas; Shalet, Stephen M
Abstract:
BACKGROUND: In adult life, considerable overlap in IGF-I status exists between normal and severely GH-deficient (GHD) subjects defined by conventional dynamic testing of GH secretion. IGF-I is not therefore widely viewed as a reliable diagnostic marker for GHD. Recognized factors influencing serum IGF-I level in GHD include age, gender, timing of onset of GHD, and exogenous estrogen therapy, but these do not fully explain GH/IGF-I discordance in severe GHD. The primary structures of prolactin and GH are closely related. Effects of hypoprolactinemia are not well described in humans, but laboratory studies suggest a role for prolactin in hepatic IGF-I release, possibly through a signal transducer and activator of transcription 5 (STAT5) pathway. The purpose of this study was to evaluate a potential contribution of prolactin to IGF-I status in severely GHD adults. PATIENTS AND METHODS: Using multiple regression analysis techniques, contributions of the following variables to age-adjusted IGF-I sd scores were evaluated in 162 (85 female) GHD adults: gender, timing of onset of GHD, presence or absence of prolactin deficiency, body mass index, number of additional pituitary deficits, and underlying pathology. RESULTS: Childhood onset GHD (P < 0.0001) and presence of prolactin deficiency (P < 0.0001) were independently associated with reduced IGF-I status. The contributions of these parameters to IGF-I sd scores were -2.55 and -2.67, respectively. Gender (P = 0.06), body mass index (P = 0.99), number of additional pituitary deficits (P = 0.64), and underlying pathology (P = 0.06) did not significantly influence IGF-I status. CONCLUSIONS: Prolactin deficiency is independently associated with reduced IGF-I status in hypopituitary adults. It is possible that prolactin deficiency is a surrogate for the degree of severity of GHD, implying a GHD paradigm undetected by conventional GH provocative tests; alternatively, it remains plausible that circulating prolactin contributes to IGF-I release in the absence of GH, possibly through a signal transducer and activator of transcription 5 (STAT5) pathway.
Affiliation:
Department of Endocrinology, Christie Hospital, Wilmslow Road, Manchester M20 4BX, United Kingdom. annice.mukherjee@christie-tr.nwest.nhs.uk
Citation:
Prolactin deficiency is independently associated with reduced insulin-like growth factor I status in severely growth hormone-deficient adults. 2006, 91 (7):2520-5 J. Clin. Endocrinol. Metab.
Journal:
The Journal of Clinical Endocrinology and Metabolism
Issue Date:
Jul-2006
URI:
http://hdl.handle.net/10541/72418
DOI:
10.1210/jc.2005-2491
PubMed ID:
16621908
Type:
Article
Language:
en
ISSN:
0021-972X
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorMukherjee, Annice-
dc.contributor.authorRyder, W David J-
dc.contributor.authorJöstel, Andreas-
dc.contributor.authorShalet, Stephen M-
dc.date.accessioned2009-07-03T12:16:37Z-
dc.date.available2009-07-03T12:16:37Z-
dc.date.issued2006-07-
dc.identifier.citationProlactin deficiency is independently associated with reduced insulin-like growth factor I status in severely growth hormone-deficient adults. 2006, 91 (7):2520-5 J. Clin. Endocrinol. Metab.en
dc.identifier.issn0021-972X-
dc.identifier.pmid16621908-
dc.identifier.doi10.1210/jc.2005-2491-
dc.identifier.urihttp://hdl.handle.net/10541/72418-
dc.description.abstractBACKGROUND: In adult life, considerable overlap in IGF-I status exists between normal and severely GH-deficient (GHD) subjects defined by conventional dynamic testing of GH secretion. IGF-I is not therefore widely viewed as a reliable diagnostic marker for GHD. Recognized factors influencing serum IGF-I level in GHD include age, gender, timing of onset of GHD, and exogenous estrogen therapy, but these do not fully explain GH/IGF-I discordance in severe GHD. The primary structures of prolactin and GH are closely related. Effects of hypoprolactinemia are not well described in humans, but laboratory studies suggest a role for prolactin in hepatic IGF-I release, possibly through a signal transducer and activator of transcription 5 (STAT5) pathway. The purpose of this study was to evaluate a potential contribution of prolactin to IGF-I status in severely GHD adults. PATIENTS AND METHODS: Using multiple regression analysis techniques, contributions of the following variables to age-adjusted IGF-I sd scores were evaluated in 162 (85 female) GHD adults: gender, timing of onset of GHD, presence or absence of prolactin deficiency, body mass index, number of additional pituitary deficits, and underlying pathology. RESULTS: Childhood onset GHD (P < 0.0001) and presence of prolactin deficiency (P < 0.0001) were independently associated with reduced IGF-I status. The contributions of these parameters to IGF-I sd scores were -2.55 and -2.67, respectively. Gender (P = 0.06), body mass index (P = 0.99), number of additional pituitary deficits (P = 0.64), and underlying pathology (P = 0.06) did not significantly influence IGF-I status. CONCLUSIONS: Prolactin deficiency is independently associated with reduced IGF-I status in hypopituitary adults. It is possible that prolactin deficiency is a surrogate for the degree of severity of GHD, implying a GHD paradigm undetected by conventional GH provocative tests; alternatively, it remains plausible that circulating prolactin contributes to IGF-I release in the absence of GH, possibly through a signal transducer and activator of transcription 5 (STAT5) pathway.en
dc.language.isoenen
dc.subject.meshAdolescent-
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshEstrogen Replacement Therapy-
dc.subject.meshFemale-
dc.subject.meshHuman Growth Hormone-
dc.subject.meshHumans-
dc.subject.meshHypopituitarism-
dc.subject.meshHypothalamic Diseases-
dc.subject.meshInsulin-Like Growth Factor I-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshProlactin-
dc.subject.meshRegression Analysis-
dc.titleProlactin deficiency is independently associated with reduced insulin-like growth factor I status in severely growth hormone-deficient adults.en
dc.typeArticleen
dc.contributor.departmentDepartment of Endocrinology, Christie Hospital, Wilmslow Road, Manchester M20 4BX, United Kingdom. annice.mukherjee@christie-tr.nwest.nhs.uken
dc.identifier.journalThe Journal of Clinical Endocrinology and Metabolismen

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