No abstract

We have evaluated the plasma GH response to a single injection of 1 microgram/kg of GH-releasing hormone (GHRH)-40 in 15 obese children and 15 age-matched control children. Most of the obese children showed a subnormal plasma GH response to GHRH and the mean plasma GH integrated area (IC-GH) following stimulation was significantly smaller in obese than control children. Plasma somatomedin-C (SM-C) levels were significantly higher in obese than control children, and were negatively correlated with the peak plasma GH levels (r = -0.616, P less than 0.01) and the IC-GH (r = -0.554, P less than 0.02) after GHRH. Non-esterified fatty acids (NEFA) and fasting plasma insulin levels were also elevated in obese children, but did not correlate with the extent of plasma GH response to GHRH. These data confirm previous observations on the refractoriness of obese children to release GH after GHRH, and imply that it may be due to the feedback inhibition operated by the elevated plasma levels of SM-C.

No abstract

The adrenal steroid secretion was studied in 6 prepubertal obese boys and 6 obese boys at the first stage of sexual maturation according to Tanner. Twelve normal boys, closely matched for age and stage of sexual maturation, were also studied as controls. Pregnenolone and dehydroepiandrosterone plasma levels were found to be significantly (P less than 0.001) higher in both groups when compared with normal boys. All the values, apart from pregnenolone in the prepubertal group, returned to normal after weight loss. Progesterone was found significantly increased (P less than 0.001) in both groups and normal after weight loss. 17-OH-progesterone plasma levels showed no significant difference between the obese and control groups. Androstenedione was increased in the prepubertal group before and normal after weight loss; no significant difference was found in the other group. Testosterone and estradiol showed normal values in the two groups both before and after weight loss. Cortisol showed a similar pattern. It can be concluded that an increased cortico-adrenal activity is present in obese boys as already reported in obese girls. This finding could explain the precocious adrenarche which often occurs in these patients. The increased adrenal androgen secretion might be due to an increased cortico adrenal stimulating hormone secretion or to an enhanced adrenal sensitivity to this hypothetical hormone.