The response of plasma growth hormone to synthetic growth hormone-releasing factor (hpGRF-44) administered intravenously was examined in normal men of various ages ranging from 20 to 75 years. Most of the subjects who were over forty years old had either no or much lower response of plasma growth hormone to hpGRF-44. In contrast plasma growth hormone increased markedly after hpGRF-44 injection in all men in their twenties and thirties. The mean peak level of plasma GH following hpGRF-44 administration was 29.6 +/- 20.4 (SD) ng/ml in men in their twenties, 30.2 +/- 26.5 ng/ml in their thirties, 9.7 +/- 5.2 ng/ml in their forties, 10.9 +/- 5.4 ng/ml in their fifties, 8.4 +/- 4.8 ng/ml in their sixties and 8.1 +/- 7.5 ng/ml in their seventies. These results suggest that somatotroph cells become less sensitive to growth hormone-releasing factor with aging.

The effect of glucose on GH-releasing hormone (GHRH)-mediated GH secretion was examined in six normal young men. In two paired experiments, the six men drank a 75-g glucose solution or an equal volume of water 30 min before receiving, iv, 100 micrograms of the 44-amino acid form of human pancreatic GHRH (hGHRH-44). One week later, the same men underwent an identical experimental protocol in a cross-over trial. Basal plasma GH concentrations before hGHRH-44 administration were not statistically different in the two experiments [glucose experiment, 2.1 +/- 0.1 (+/- SE) ng/ml; water experiment, 2.6 +/- 0.6 ng/ml]. The mean peak plasma GH level occurred 30 min after hGHRH-44 administration in both experiments. However, the mean GH response was significantly diminished when the men received glucose (8.12 +/- 1.12 ng/ml) compared to that when they received only water (23.70 +/- 8.46 ng/ml; P less than 0.01). Thus, hyperglycemia may exert an inhibitory effect on the plasma GH response to hGHRH-44.

Corticotropin-releasing factor (CRF) tests were performed in normal subjects and patients with hypothalamic-pituitary-adrenal disorders. In normal subjects, after iv administration of 500 micrograms synthetic ovine CRF, plasma ACTH rose significantly to approximately 3.6 times the basal level at 30-60 min and cortisol reached a peak of 2.3 times the basal level at 60-90 min, whereas aldosterone peaked at 1.6 times the basal level at 60 min. Injection of 100 micrograms CRF in normal subjects also caused a significant increase in plasma ACTH and cortisol levels but only a slight increase in aldosterone. However, the total hormone released and their peak levels were lower than those elicited by the 500-microgram dosage. In patients with Cushing's disease, although the basal and peak levels of plasma ACTH and cortisol induced by administration of CRF were variable, the ratios of increase for the two hormones elicited by CRF were lower than those in normal subjects, especially for cortisol. In patients with Cushing's syndrome due to an adrenal adenoma, basal levels of ACTH were markedly suppressed and plasma ACTH and cortisol did not rise after CRF. In patients with isolated ACTH deficiency or Sheehan's syndrome the basal level of plasma ACTH was less than 5 pg/ml and no change in plasma ACTH occurred after injection of CRF. In patients with Nelson's syndrome or Addison's disease the basal levels of ACTH were extremely elevated but infusion of CRF increased plasma ACTH to even higher levels.