A Study of Adrenal Cortical Function in Acromegaly

Roginsky, Martin S.; Shaver, Joyce C.; Christy, Nicholas P.

doi:10.1210/jcem-26-10-1101

Cited by 19 publications

(5 citation statements)

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“…Sklar and Ulstrom [5], found no effect of 6 months of treatment with pituitary growth hormone on either urinary 17-kctosteroids or plasma DHEA-S levels. Patients with acromegaly may have increased production of both cortisol and adrenal androgens [6,7], although this may result more from increased steroid hormone metabolic clearance than stimulation directly by GH [7], In the present study, rhGH treatment re sulted in substantial retention of sodium, potassium and water, as has been decribed previously with pituitary growth hormone [8], Serum sodium levels increased signifi cantly, while at the same time potassium levels decreased significantly. Aldosterone secretion, as estimated from plasma levels and urinary excretion rates, did not change during treatment with rhGH, whereas uri nary aldosterone excretion increased by more than 50% over a several-day period imme diately after treatment.…”

supporting

confidence: 67%

“…Receptors for insulin-like growth fac tor-1 (IGF-1), the peptide hormone derived from growth hormone, have been identified in the rat adrenal [3], When experimental ani mals or humans have been given pituitaryextracted growth hormone, variable effects on adrenocortical secretion were seen [4][5][6][7]. We report here on the effects of intense treatment of healthy adults with rhGH on the secretory function of the zonae fasciculata, glomerulosa.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Recombinant Human Growth Hormone on Adreno- cortical Function, and on Sodium and Potassium Homeostasis

Pratt

Peacock²,

Henry

1993

Pharmacology

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In the present study we examined the effect of treatment with recombinant human growth hormone (rhGH) on adrenocortical secretory function, as well as sodium and potassium balance. rhGH, 100 μg/kg per day, was given for 4 days. Both glucocorticoid and androgen secretion were unaffected by treatment as evidence by unchanged levels of cortisol and dehydroepiandrosterone-sulfate. rhGH resulted in retention of sodium and potassium and a decrease in serum potassium concentration, but neither aldosterone plasma levels nor urinary excretion rates changed until after treatment. During the rhGH washout phase, a natriuresis ensued, but this occurred slowly possibly in part because a higher serum potassium stimulated aldosterone secretion. In summary, short-term treatment with rhGH had no immediate effect on adrenocortical function, but caused pronounced retention of electrolytes. In the posttreatment period, there were increases in aldosterone secretion accompanied by delayed recovery from the retention of sodium.

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supporting

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Effect of Recombinant Human Growth Hormone on Adreno- cortical Function, and on Sodium and Potassium Homeostasis

Pratt

Peacock²,

Henry

1993

Pharmacology

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“…Adrenocortical function in patients with active acromegaly had been previously reported as normal (Roginsky et al, 1966) or slightly elevated (Charro et al, 1973). Responses to ACTH, dexamethasone, and metyrapone, however, were normal in most acromegalic patients (Charro et al, 1973).…”

Section: Nor In Patients Withmentioning

confidence: 90%

POTENTIATION OF THE HYPOTHALAMIC‐PITUITARY‐ADRENAL RESPONSE TO METYRAPONE BY l‐DOPA IN ACROMEGALIC PATIENTS

Hsu

1978

Clinical Endocrinology

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SUMMARY The effects of l‐DOPA administration on hypothalamic‐pituitary‐adrenal function were studied in five normal subjects and in five patients with active acromegaly. In acromegalic patients, oral l‐DOPA (500 mg every 4 h for six doses) failed to alter the urinary excretion of 17‐hydroxycorticoids (17‐OHCS), 17‐oxosteroids (17‐OS), and tetrahydro‐11‐desoxycortisol (tetrahydro‐comp S). However, when cortisol synthesis was blocked with oral metyrapone, enhancement of excretion of 17‐OHCS, 17‐OS, and tetrahydro‐comp S by l‐DOPA became apparent in acromegalic patients but not in the normals. In patients with acromegaly, on the day of metyrapone administration, the mean excretion rates of 17‐OHCS, 17‐OS, and of tetrahydro‐comp S were 8.6 mg, 6.4 mg and 4.1 mg/24 h, respectively. When 500 mg l‐DOPA was co‐administered with metyrapone, the corresponding values increased significantly (P<0.01) to 14.9 mg, 9.0 mg and 7.7 mg/24 h. This effect of l‐DOPA was not observed in the normal subjects. It was concluded that l‐DOPA markedly enhanced the hypothalamic‐pituitary‐adrenal response to metyrapone in acromegalic patients, but not in normal subjects. l‐DOPA (or one of its metabolites) probably acts upon a noradrenergic or a dopaminergic system located in the hypothalamus to alter the release of ACTH. The unusual pituitary‐adrenal response to l‐DOPA in acromegaly may reflect: (1) a supersensitive reaction of the pituitary‐adrenal axis to l‐DOPA; (2) a paradoxical response of the pituitary‐adrenal axis to l‐DOPA; or (3) a subtle pituitary‐adrenal dysfunction.

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“…Our failure lo find any evidence of increased melanization sebaceous gland enlargement, or increased growth of hair may reflect inadequate dosage of the hormone, or loo short a period of treatment. Alternatively, it may be that not all of the alterations observed in acromegaly are caused directly by hypersomatotropism, but rather may relate to increased secretion of ACTH or MSH, or lo increased production of adrenal androgcns (Lim & Dingman 1964, Roginsky et al 1966. Those components of the skin whieh did not seem to respond to hGH, but whieh are prominently increased in acromegaly, arc well known to be responsive to these other hormones.…”

Section: Discussionmentioning

confidence: 99%

Dermal Changes in Osteoporosis Following Prolonged Treatment with Human Growth Hormone

Aloia

Grover

1976

J Cutan Pathol

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Five patients with osteoporosis were treated with human growth hormone (hGH) for a year and the changes in their skin were studied by light and electron microscopy. The abnormally thin skin of osteoporosis appeared to change towards normal after treatment with hGH. There was a consistent proliferation of blood vessels, and increased number of mast cells and fibrocytes. The collagen bundles and elastic tissue fibers appeared hyperplastic and more horizontally oriented. The fine, vertical elastic fibrils of the papillary dermis had appeared decreased before treatment, but seemed to be restored to their normal configuration after treatment. Since there was no evidence of stimulation of hair, sebum, or melanin such as occurs in acromegaly, it is suggested that the scope of the direct action of hGH on the skin is limited to mesenchymal structures.

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A Study of Adrenal Cortical Function in Acromegaly

Cited by 19 publications

References 0 publications

Effect of Recombinant Human Growth Hormone on Adreno- cortical Function, and on Sodium and Potassium Homeostasis

Effect of Recombinant Human Growth Hormone on Adreno- cortical Function, and on Sodium and Potassium Homeostasis

POTENTIATION OF THE HYPOTHALAMIC‐PITUITARY‐ADRENAL RESPONSE TO METYRAPONE BY l‐DOPA IN ACROMEGALIC PATIENTS

Dermal Changes in Osteoporosis Following Prolonged Treatment with Human Growth Hormone

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