We studied the effects of recombinant growth hormone on systemic nitric oxide (NO) formation and hemodynamics in a double-blind, placebo-controlled trial in adult patients with acquired growth hormone deficiency. 30 patients were randomly allocated to either recombinant human growth hormone (r-hGH; 2.0 IU/d) or placebo for 12 mo. In the subsequent 12 mo, the study was continued with both groups of patients receiving r-hGH.In months 1, 3, 6, 9, and 12 of each year, urine and plasma samples were collected for the determination of urinary nitrate and cyclic GMP as indices of systemic NO production, and of plasma IGF-1 levels. Cardiac output was measured in months 1, 12, and 24 by echocardiography.r-hGH induced a fourfold increase in plasma IGF-1 concentrations within the first month of treatment. Urinary nitrate and cyclic GMP excretion rates were low at baseline in growth hormone-deficient patients (nitrate, 96.8 Ϯ 7.4 mol/ mmol creatinine; cyclic GMP, 63.6 Ϯ 7.1 nmol/mmol creatinine) as compared with healthy controls (nitrate, 167.3 Ϯ 7.5 mol/mmol creatinine; cyclic GMP, 155.2 Ϯ 6.9 nmol/mmol creatinine). These indices of NO production were significantly increased by r-hGH, within the first 12 mo in the GH group, and within the second 12 mo in the placebo group. While systolic and diastolic blood pressure were not significantly altered by r-hGH, cardiac output significantly increased by 30-40%, and total peripheral resistance decreased by ‫ف‬ 30% in both groups when they were assigned to r-hGH treatment. In the second study year, when both groups were given r-hGH, there were no significant differences in plasma IGF-1, urinary nitrate, or cyclic GMP excretion, or hemodynamic parameters between both groups.In

No abstract

Abstract. A recently developed highly sensitive immunoradiometric thyrotropin (TSH) assay capable to distinguish between euthyroid and hyperthyroid TSH-levels was used to evaluate the secretion-pattern of TSH in 10 healthy male subjects by taking blood via an indwelling venous catheter at 10 min intervals over 24 h. Visual analysis revealed a pulsatile pattern of hormone release with an average of 10.3 peaks/24 h. Evaluation by computer assisted programs such as the Santen-program (8.9 peaks/24 h, amplitude 0.60 mU TSH/l), the 'Pulsar'-program (6 peaks/24 h, amplitude 0.61 mU TSH/l) or power-spectrum analysis (11.9 peaks/24 h) showed similar results. These data suggest a pulsatile mechanism of TSH secretion similar to other pituitary hormones.

Growth hormone (GH) has been used for over 35 years, and its safety and efficacy has been studied extensively. Experimental studies showing the permissive role of GH/insulin-like growth factor 1 (IGF-I) in carcinogenesis have raised concerns regarding the safety of GH replacement in children and adults who have received treatment for cancer and those with intracranial and pituitary tumours. A consensus statement was produced to guide decision-making on GH replacement in children and adult survivors of cancer, in those treated for intracranial and pituitary tumours and in patients with increased cancer risk. With the support of the European Society of Endocrinology, the Growth Hormone Research Society convened a Workshop, where 55 international key opinion leaders representing 10 professional societies were invited to participate. This consensus statement utilized: (1) a critical review paper produced before the Workshop, (2) five plenary talks, (3) evidence-based comments from four breakout groups, and (4) discussions during report-back sessions. Current evidence reviewed from the proceedings from the Workshop does not support an association between GH replacement and primary tumour or cancer recurrence. The effect of GH replacement on secondary neoplasia risk is minor compared to host- and tumour treatment-related factors. There is no evidence for an association between GH replacement and increased mortality from cancer amongst GH-deficient childhood cancer survivors. Patients with pituitary tumour or craniopharyngioma remnants receiving GH replacement do not need to be treated or monitored differently than those not receiving GH. GH replacement might be considered in GH-deficient adult cancer survivors in remission after careful individual risk/benefit analysis. In children with cancer predisposition syndromes, GH treatment is generally contraindicated but may be considered cautiously in select patients.

The validity of skeletal muscle function as a functional measure of nutritional state was determined by stimulating the ulnar nerve at the wrist and measuring the force of isometric contractions of the adductor pollicis muscle. Nutritional state was evaluated by measuring body composition, by multiple-isotope dilution, in 21 malnourished and 44 normally nourished patients. No significant correlation between body composition and muscle function was found. In eight normally nourished volunteers, muscle function was determined before, after 24 and 48 h of complete starvation, and 6, 24, and 48 h following resumption of normal diet. Muscle function became abnormal after 24 h of starvation and deteriorated further after 48 h. Six hours following a single normal meal, muscle function returned to normal. Experimental data indicate that the response of the adductor pollicis muscle to ulnar nerve stimulation is not an accurate measure of nutritional state.