Paradoxical Elevation of Growth Hormone in Active Chronic Hepatitis

Becker, MervynD.; Cook, Gordon; Wright, Alex

doi:10.1016/s0140-6736(69)90643-6

Cited by 48 publications

(10 citation statements)

References 25 publications

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“…However, in both groups there was also a paradoxical rise in growth hormone concentration towards the end of the glucose tolerance test. This has been noted previously in active chronic hepatitis (Becker, Cook & Wright, 1969;Alberti et al, 1972), cirrhosis (Conn & Daughaday, 1970), diabetes mellitus (Yde, 1969) and other unrelated conditions (see Becker et al, 1969), emphasizing its lack of specificity. The reason for this rise at that time is obscure.…”

Section: Discussionsupporting

confidence: 53%

Disturbances in Glucose Metabolism in Patients with Liver Damage Due to Paracetamol Overdose

et al. 1975

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1. Intravenous glucose tolerance test were performed in fourteen patients with mild or moderate liver damage due to paracetamol overdose. 2. In patients managed conservatively there was glucose intolerance associated with a diminished early insulin response to glucose, suggesting inadequate nutrition in the period between the overdose and the glucose tolerance test. 3. Patients given intravenous glucose supplements to maintain nutrition were also glucose intolerant and, in these, insulin responses to glucose were normal. The decreased fractional disappearance rate was partly due to an increase in glucose distribution space and partly due to a decrease in absolute glucose disappearance rate. 4. Impaired gluconeogenesis was suggested by mild fasting hypoglycaemia in four patients and raised fasting blood lactate concentrations. Serum growth hormone concentrations showed a paradoxical increase after glucose. 5. All these variables had returned to normal in four patients re-tested after recovery.

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Section: Discussionsupporting

confidence: 53%

Disturbances in Glucose Metabolism in Patients with Liver Damage Due to Paracetamol Overdose

et al. 1975

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“…Similar abnormalities in GH levels and/or response to variations in glucose homeostasis have been described in several conditions, including acromegaly, renal failure, anorexia nervosa, and chronic liver disease (10)(11)(12)(13). Nonspecific release of GH by TRH is found in patients with these disorders (14)(15)(16)(17)(18)(19)(20), prompting the suggestion that TRH-induced GH release is a characteristic of conditions in which normal central nervous system influences for the control of GH secretion have been temporarily or permanently impaired (19).…”

mentioning

confidence: 74%

Growth Hormone Response to Thyrotropin-Releasing Hormone in Diabetes*

Dasmahapatra

Urdanivia

Cohen

1981

The Journal of Clinical Endocrinology & Metabolism

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The effect of TRH on GH secretion was assessed in 13 insulin-dependent diabetics. PRL and TSH responses to TRH were also determined. Glycosylated hemoglobin levels and serial fasting glucose concentrations indicated that all but 1 of the patients had a period of poor diabetic control for several months before the study. Peak PRL and TSH levels after TRH injection in these diabetic patients did not differ significantly from values observed in nondiabetic individuals. Six of the patients responded to TRH with a significant rise in GH levels; basal GH concentrations were also elevated in these patients. Five of the 6 responders and none of the nonresponders had proliferative diabetic retinopathy. The results suggest that diabetics with elevated basal GH levels hyperrespond to TRH, and that nonspecific secretion of GH in response to TRH occurs in some patients with proliferative diabetic retinopathy. Chronic hyperglycemia does not appear to be the critical factor in determining this response.

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“…Two theories have been put forward to explain the paradoxical GI-I reactions in the newborn: One postulates that the aberrant reaction is due to the very different metabolic state of the newborn. The high values for GH of up to 320 ng/ml [12] [4] found the same phenomenon in 8 of 14 patients with active chronic hepatitis. The authors discussed a possible influence of reduced metabolism of GH and delevated estrogen levels but these factors could not explain the paradoxical reaction.…”

Section: Discussionmentioning

confidence: 68%

The paradoxical growth hormone reaction after intravenous glucose in the newborn

et al. 1974

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Abstract. Intravenous glucose tests (0.5 g/kg body weight) were performed in 13 newborn infants during their first 3 days of life. The variations in blood glucose, insulin and GH values were studied. In all patients there was a rise in plasma insulin. The correlation between initial insulin rise and glucose assimilation constant was 0.503 which is almost significant. The glucose load provoked a very variable response in plasma GH concentration, some infants showed a rise, others a fall. If the newborns were grouped according to this reaction it appeared that the GK response could be explained using Wilder's law of initial value. This hypothesis, however, did not stand up to a thorough statistical analysis including a discussion of a less well-known statistical error.In contrast to insulin secretion, GH apparently plays no major role in the short term regulation of the blood sugar in the newborn.Key words: Growth hormone --Newborn --Glucose load --Insulin. ExtractAn intravenous glucose load Jn 13 newborns showed a high glucose assimilation constant (k) of 4.81 j: 1.39. A positive correlation (r = 0.503) was found between k and the rise of insulin concentration within 2 min after injection of glucose. Plasma GH (growth hormone) concentrations varied widely with a high mean initial value (48.3 ng/ml), and no distinct pattern (neither a fall nor an increase) was provoced by glucose load. There was no correlation between variations of GH concentration and glucose assimilation. The present study suggests that the regulation of GIt secretion is not yet established in the early postnatal period. Therefore an increase in GIt concentration after glucose load is a coincidence rather than a "paradoxical" reaction. SpeculationRegulation of GH secretion based on negative correlation between blood glucose and GH concentration becomes effective only in the late 64 P.W. Nars et al.neonatal period. Because the mean levels of GH concentration are very high in the early postnatal period variations in GH concentrations do not affect glucose assimilation.

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Paradoxical Elevation of Growth Hormone in Active Chronic Hepatitis

Cited by 48 publications

References 25 publications

Disturbances in Glucose Metabolism in Patients with Liver Damage Due to Paracetamol Overdose

Disturbances in Glucose Metabolism in Patients with Liver Damage Due to Paracetamol Overdose

Growth Hormone Response to Thyrotropin-Releasing Hormone in Diabetes*

The paradoxical growth hormone reaction after intravenous glucose in the newborn

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