Preservation of growth hormone pulsatility despite pituitary pathology, surgery, and irradiation.

2.50
Hdl Handle:
http://hdl.handle.net/10541/94694
Title:
Preservation of growth hormone pulsatility despite pituitary pathology, surgery, and irradiation.
Authors:
Toogood, Andy; Nass, R M; Pezzoli, S S; O'Neill, Paul A; Thorner, M O; Shalet, Stephen M
Abstract:
Detailed assessment of physiological and pathophysiological GH secretion has, until recently, been limited by the poor sensitivity of the available assays. We have used an ultrasensitive chemiluminescence GH assay (sensitivity, 0.002 microgram/L) to study 24-h GH profiles (20-min sampling) from 24 patients who had been treated for hypothalamic-pituitary disease with surgery and irradiation and from 24 healthy control subjects matched for age, sex, and body mass index. Twenty-three of the 24 patients demonstrated pulsatile GH secretion, determined by Cluster. The median (range) area under the curve for GH, mean pulse area, mean pulse height, average valley mean level, and mean interpeak nadir were lower in the patients than in the controls [119.25 (7.273-843.600) vs. 968.539 (227.200-4625.000) min/microgram.L (P < 0.00001); 3.777 (0.288-30.850) vs. 61.390 (12.880-224.210) min/microgram.L (P < 0.00001), 0.107 (0.010-0.958) vs. 1.408 (0.368-5.050) micrograms/L (P < 0.00001), 0.074 (0.006-0.415) vs. 0.348 (0.048-2.350) microgram/L (P < 0.00001), and 0.066 (0.003-0.270) vs. 0.205 (0.021-1.838) microgram/L (P = 0.0004), respectively]. The median (range) number of pulses, mean pulse duration, and mean interval between pulses did not differ between the patients and controls [10 (4-15) vs. 10 (7-15; P = 0.36), 96.4 (68.0-220.0) vs. 104.0 (72.0-151.4) min (P = 0.65) and 128.0 (92.8-255.0) vs. 126.2 (90.0-180.0) min (P = 0.73), respectively]. The diurnal rhythm of GH secretion was present in the controls, but there was only limited evidence of residual diurnal rhythm in the patients. This study has demonstrated that GH secretion remains pulsatile in GH-deficient patients despite the mass effect of hypothalamic-pituitary pathology, pituitary surgery, and radiotherapy. With the development of potent GH secretagogues that are active orally, our findings may have important implications for the future management of GH-deficient subjects.
Affiliation:
Department of Endocrinology, Christie Hospital, Withington, Manchester, United Kingdom.
Citation:
Preservation of growth hormone pulsatility despite pituitary pathology, surgery, and irradiation. 1997, 82 (7):2215-21 J. Clin. Endocrinol. Metab.
Journal:
Journal of Clinical Endocrinology and Metabolism
Issue Date:
Jul-1997
URI:
http://hdl.handle.net/10541/94694
DOI:
10.1210/jc.82.7.2215
PubMed ID:
9215297
Type:
Article
Language:
en
ISSN:
0021-972X
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorToogood, Andyen
dc.contributor.authorNass, R Men
dc.contributor.authorPezzoli, S Sen
dc.contributor.authorO'Neill, Paul Aen
dc.contributor.authorThorner, M Oen
dc.contributor.authorShalet, Stephen Men
dc.date.accessioned2010-03-23T12:54:56Z-
dc.date.available2010-03-23T12:54:56Z-
dc.date.issued1997-07-
dc.identifier.citationPreservation of growth hormone pulsatility despite pituitary pathology, surgery, and irradiation. 1997, 82 (7):2215-21 J. Clin. Endocrinol. Metab.en
dc.identifier.issn0021-972X-
dc.identifier.pmid9215297-
dc.identifier.doi10.1210/jc.82.7.2215-
dc.identifier.urihttp://hdl.handle.net/10541/94694-
dc.description.abstractDetailed assessment of physiological and pathophysiological GH secretion has, until recently, been limited by the poor sensitivity of the available assays. We have used an ultrasensitive chemiluminescence GH assay (sensitivity, 0.002 microgram/L) to study 24-h GH profiles (20-min sampling) from 24 patients who had been treated for hypothalamic-pituitary disease with surgery and irradiation and from 24 healthy control subjects matched for age, sex, and body mass index. Twenty-three of the 24 patients demonstrated pulsatile GH secretion, determined by Cluster. The median (range) area under the curve for GH, mean pulse area, mean pulse height, average valley mean level, and mean interpeak nadir were lower in the patients than in the controls [119.25 (7.273-843.600) vs. 968.539 (227.200-4625.000) min/microgram.L (P < 0.00001); 3.777 (0.288-30.850) vs. 61.390 (12.880-224.210) min/microgram.L (P < 0.00001), 0.107 (0.010-0.958) vs. 1.408 (0.368-5.050) micrograms/L (P < 0.00001), 0.074 (0.006-0.415) vs. 0.348 (0.048-2.350) microgram/L (P < 0.00001), and 0.066 (0.003-0.270) vs. 0.205 (0.021-1.838) microgram/L (P = 0.0004), respectively]. The median (range) number of pulses, mean pulse duration, and mean interval between pulses did not differ between the patients and controls [10 (4-15) vs. 10 (7-15; P = 0.36), 96.4 (68.0-220.0) vs. 104.0 (72.0-151.4) min (P = 0.65) and 128.0 (92.8-255.0) vs. 126.2 (90.0-180.0) min (P = 0.73), respectively]. The diurnal rhythm of GH secretion was present in the controls, but there was only limited evidence of residual diurnal rhythm in the patients. This study has demonstrated that GH secretion remains pulsatile in GH-deficient patients despite the mass effect of hypothalamic-pituitary pathology, pituitary surgery, and radiotherapy. With the development of potent GH secretagogues that are active orally, our findings may have important implications for the future management of GH-deficient subjects.en
dc.language.isoenen
dc.subject.meshAge Factors-
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshBody Mass Index-
dc.subject.meshCircadian Rhythm-
dc.subject.meshFemale-
dc.subject.meshGrowth Hormone-
dc.subject.meshHumans-
dc.subject.meshHypopituitarism-
dc.subject.meshInsulin-Like Growth Factor I-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPituitary Diseases-
dc.subject.meshSex Factors-
dc.titlePreservation of growth hormone pulsatility despite pituitary pathology, surgery, and irradiation.en
dc.typeArticleen
dc.contributor.departmentDepartment of Endocrinology, Christie Hospital, Withington, Manchester, United Kingdom.en
dc.identifier.journalJournal of Clinical Endocrinology and Metabolismen
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