Spontaneous pulsatility and pharmacokinectics of growth hormone in liver cirrhotic patients

Dysfunction of the hypothalamic-pituitary-glandular axes and relation to Child-Pugh classification in male patients with alcoholic and virus-related cirrhosis

“…IGF-1 serum levels were significantly lower in cirrhotics than in controls and were correlated negatively to Child-Pugh score. These data confirm previously reported studies [4,13]. Low IGF-1 serum levels will lead to a stimulation of the hypothalamus, resulting in increased GHRH release [17].…”

“…The ChildPugh classification scheme is commonly used to classify the severity of liver impairment [1]. Alterations in the endocrine system [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] such as pituitary function have been described, but only some of these studies addressed changes of pituitary and peripheral hormone levels in relation to disease severity (Child-Pugh classification) and aetiology [3,4,7,16,22,23]. To the best of our knowledge, no combined pituitary stimulation test has been carried out to evaluate anterior pituitary function in alcoholic and virus-related cirrhotics.…”

“…A paradoxical increase of growth hormone after oral glucose tolerance testing [2] and after thyrotropin-releasing hormone (TRH) [19] was found in some cirrhotic patients, as was an increased spontaneous pulsatility of growth hormone [4]. However, these studies were carried out without consideration of the severity of liver impairment.…”

Growth hormone-stimulated IGF-1 generation in cirrhosis reflects hepatocellular dysfunction

“…A third explanation would implicate the low IGFBP-3 binding protein levels. However, in a previous study, we demonstrated IGF-1 release to be different at the same IGFBP-3 levels in CP class A and B patients [42]. Methanol extraction may also limit accuracy of IGF-1 measurement in the serum containing protease.…”

A 24‐Hour Comparison of Serum Growth Hormone Concentrations in Patients with Heart Failure versus Healthy Controls

“…10 Neither study evaluated 24-hour growth hormone concentrations, which may be important since several surges occur throughout the day in healthy subjects. [11][12][13][14] In addition, patients with both acromegaly and CHF have higher endogenous growth hormone concentrations than those with acromegaly but no CHF. Also, in a patient with CHF and acromegaly, a reduction in growth hormone with octreotide administration improved surrogate end points.…”