Increased Growth Hormone Pulse Frequency in Acromegaly*

Barkan, Ariel L.; Stred, Susan E.; Reno, Kathleen; Markovs, Mara E.; Hopwood, Nancy J.; Kelch, Robert P.; Beitins, Inese Z.

doi:10.1210/jcem-69-6-1225

Cited by 100 publications

(45 citation statements)

References 36 publications

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“…Previous research has reported the mean frequency of GH pulses in 6 healthy males to be 4.3 pulses (range = 2 to 8 pulses) over a 24 hour period (28). Unlike the GH increases observed in this study natural GH pulses were shown to vary largely in their time of occurrence.…”

Section: Discussioncontrasting

confidence: 78%

Increases in Serum Growth Hormone Concentrations Associated with GHB Administration

et al. 2016

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The administration of gamma-hydroxybutyrate (GHB) has been reported to augment the increase in growth hormone (GH) secretion associated with the onset of sleep. The ability of GHB to stimulate GH production in the absence of sleep in both male and female volunteers was investigated as part of a GHB administration study.Twelve healthy volunteers (6 men and 6 women) were given a small oral dose (25 mg/kg) of GHB (as Xyrem®) at 10:00 h. Basal blood samples (as serum) were taken 10 min prior to GHB administration, with additional samples taken at 10,15,20,25,30, 45, 60, 90, 120, 150, 180, 240, 360 and 480 min post-administration. The serum concentrations of GHB were measured by GC-MS and GH by immunometric assay.Following GHB administration, volunteers exhibited effects consistent with mild sedation, i.e. relaxed with normal responses to verbal stimuli. Despite none being asleep, an increase in serum GH concentration occurred in 11 out of the 12 volunteers (5 women and 6 men). In these volunteers, peak GH concentrations occurred 45 -60 min post-administration compared to a mean serum t max for GHB of 23 min (sd = 5.4 min). The absolute increase in GH was similar for the men and women, averaging 3.4 ng/mL and 3.7 ng/mL respectively. The mean intra-individual increase in GH was much greater in males (29 times) compared with females (2 times), as males had (as expected) lower basal GH concentrations (mean = 0.26 ng/mL) compared to females (mean = 5.4 ng/mL). After maximising, the GH C max decreased rapidly (in agreement with GHB concentrations), returning to basal concentrations at around 90 -120 min post-administration. GHB administration at low therapeutic concentrations results in increases in serum GH concentrations in healthy male and female volunteers in the absence of sleep onset.3

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Section: Discussioncontrasting

confidence: 78%

Increases in Serum Growth Hormone Concentrations Associated with GHB Administration

et al. 2016

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“…Growth hormone (GH) secretion in clinically active acromegaly is characterized by increased pulse frequency, and raised basal (nonpulsatile) secretion (1,2,3). Recent studies, applying a new regularity statistic, approximate entropy (ApEn), have revealed that the GH secretion pattern is also highly irregular (4,5,6).…”

Section: Introductionmentioning

confidence: 99%

Reduced disorderliness of growth hormone release in biochemically inactive acromegaly after pituitary surgery

Berg

Pincus

Frölich

et al. 1998

European Journal of Endocrinology

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The episodicity of 24 h GH release was studied in 18 patients with active acromegaly, 12 patients 7-10 days after pituitary surgery, 14 patients long after operation (3-17 years), and 21 healthy gender-and age-matched control subjects, using a recently introduced scale-and model-independent regularity statistic, approximate entropy (ApEn). Blood samples were taken at 10-min intervals for 24 h, and plasma GH concentrations were measured by immunofluorometric assay (detection limit 11.5 ng/l). For this study we selected operated patients who were biochemically in remission, defined by normal circulating IGF-I and insulin-like growth factor-binding protein-3 (IGFBP-3) concentrations, normal glucose-suppressed plasma GH concentration (<0.38 mg/l), and the normalization of the paradoxical rise of GH to TRH or GnRH. In patients with active acromegaly ApEn was 1.23 Ϯ 0.04, with no overlap with the control subjects (P ¼ 1.2 × 10 ¹16 ), who had an ApEn of 0.40 Ϯ 0.04. ApEn in patients shortly after surgery was 0.71 Ϯ 0.09 (P < 0.001 vs controls), and long after surgery 0.56 Ϯ 0.05 (P < 0.011 vs controls). ApEn values in treated and untreated patients correlated significantly with the plasma concentration of IGF-I (r ¼ 0.531) and IGFBP-3 (r ¼ 0.598), and the log-transformed 24 h GH secretion rate (r ¼ 0.749). Shortly after surgery only one-third of the patients had a normal ApEn value, whereas long after surgery about 70% of the patients had a normal ApEn value. Although ApEn eventually normalized in about 70% of the operated patients, the cause of the persistence of abnormal GH release in the remainder of the subjects is not known, and might reflect permanent hypothalamic-pituitary dysfunction or a very early recurrence of the somatotroph adenoma.

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“…Increased GH in response to TRH stimulation may also be observed during the course of gestation in acromegalic patients, whereas placental GH does not respond to TRH (110,113). The increased, but highly pulsatile GH levels might be a clue for the diagnosis of acromegaly during pregnancy (110,114).…”

Section: Diagnosis Of Acromegaly During Pregnancymentioning

confidence: 99%

Pregnancy and pituitary disorders

Karaca¹,

Tanrıverdi²,

Ünlühızarcı³

et al. 2010

European Journal of Endocrinology

164

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Major hormonal changes emerge during pregnancy. The pituitary gland is one of the most affected organs with altered anatomy and physiology. The pituitary gland is enlarged as a result of lactotroph hyperplasia. Due to physiological changes in the pituitary and target hormone levels, binding globulins, and placental hormones, hormonal evaluation becomes more complex in pregnant women. As a consequence of physiological hormonal changes, the evaluation of pituitary functions in pregnant women is quite different from that done in the prepregnant state. Pituitary adenomas may cause problems by their hormone secretion that affects the mother and the fetus besides causing an increased risk of tumor growth. Furthermore, diagnosis, course, and treatment of pituitary diseases point out differences. The changes in anatomy and physiology of the pituitary gland during pregnancy are reviewed. Pituitary disorders namely Cushing's disease; acromegaly; prolactinoma; TSH-secreting, gonadotropin-producing, and clinically nonfunctioning adenomas; craniopharyngioma; and Sheehan's syndrome, which is one of the most common causes of hypopituitarism, lymphocytic hypophysitis, and hypopituitarism, in relation to pregnancy are discussed. Being aware of all this information will prevent any serious problems which mother and child will be exposed to.

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Increased Growth Hormone Pulse Frequency in Acromegaly*

Cited by 100 publications

References 36 publications

Increases in Serum Growth Hormone Concentrations Associated with GHB Administration

Increases in Serum Growth Hormone Concentrations Associated with GHB Administration

Reduced disorderliness of growth hormone release in biochemically inactive acromegaly after pituitary surgery

Pregnancy and pituitary disorders

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