Selective impairment of growth hormone response to physiological stimuli.

The Short Child with Subnormal Plasma Somatomedin C

“…A study similar to the present one, but based on only one SmC determination per child, was published by Bala et al (9). We have estimated from their graphic data the mean SmC + 1 SD for ages 7-9 to be 0.46 + 0.30 unit/ml for boys, and 0.66 + 0.31 for girls.…”

“…A second possibility is a failure of nocturnal secretion of hGH as described by Wise et al (9); this has been ruled out by the nocturnal serum GH data (10). Other causes cannot be excluded: Impaired hepatic production of SmC; nutritional disorders (1 1); abnormally rapid clearance of SmC; an altered SmC binding system (12); or a bioinactive GH (3-5) are possible, but are generally outside the scope of the present data.…”

Spontaneous Growth Hormone Secretion and Plasma Somatomedin-C in Children of Short Stature.

“…Several groups have reported that short children whose nocturnal GH values were somewhat lower than those of controls have accelerated growth after replacement therapy with HGH (Wise et al, 1975;Bierich and Potthoff, 1979;Spiliotis et al, 1984). Thus, it would be worthwhile to confirm whether these short children can respond to therapy with exogeneous GH.…”

“…Human growth hormone (HGH) therapy has been attempted in short children to obtain both the normal serum GH responses to provocative stimulation and low sleeprelated serum GH concentrations, and has subsequently increased their growth rates (Wise et al, 1975;Spiliotis et al, 1984). Furthermore, the plasma somatomedin (SM) levels of such children rose significantly with GH therapy (Kowarski et al, 1978;Rudman et al, 1981;Frazer et al, 1982;Vliet et al, 1983;Gertner et al, 1984).…”

Growth Hormone Responses to Sleep, Insulin Hypoglycaemia and Arginine Infusion

“…None of these are entirely reli able, all giving a percentage of false-negative results [4]. To reduce the chances of obtain ing a misleading result many investigators use at least two stimulation tests and these are often performed sequentially [5,6], There are case reports of children who have normal GH responses (> 15 mli/1) to stimulation tests but have subnormal levels of GH during natural sleep [7][8][9], Some of these children have been treated with human GH and have responded with an increased height velocity [7][8][9], We have seen a number of children who have grown poorly despite peak serum GH concentrations greater than 15 mU/1 following stimulation tests and we have wondered whether these children fail to secrete GH normally during sleep. This study was designed to compare sleep-related GH secretion with serum GH responses to the sequential insulin-induced hypoglycaemiaarginine infusion test usually used in our de partment.…”