Sweat secretion rates in growth hormone disorders

Abstract

We have demonstrated that longstanding GH hypersecretion in patients with acromegaly induces irreversible changes of sweat gland function, with persistently elevated SSR despite treatment and clinical cure. In GHD patients, SSR was reduced in males but not in females, which together with the established gender difference in normal controls emphasises the role of androgen deficiency as a cofactor for reduced sweating in hypopituitary patients. Sweat gland development seems to be more susceptible to lack of hormones in childhood and adolescence than in adulthood, whereas growth hormone excess can modify sweat function later in life.

Skin morphological changes in growth hormone deficiency and acromegaly

“…In a previous study involving patients with AO-GHD of mean duration 8.6 years (range 2±27 years) since diagnosis, we found that SSR was similar to controls in female patients, but lower compared with controls in male patients. Eighteen months of GH replacement therapy did not effect SSR in either group (4). In the present study, only male patients were present in the untreated GHD group.…”

“…The impact of the decreased sweating ability is also demonstrated by the fact that some patients with GHD are poikilothermic (13). Conversely, acromegaly is associated with excess sweating and increased SSR (4,8). The changes in GHD may be a result of atrophy of the eccrine sweat glands because of lack of stimulation of either GH or IGF-I, or both.…”

“…This hypothesis originates from the ®nding that in situations of stress, impaired sweating capacity, as seen in GHD (3,4), is associated with a risk of hyperthermia (6,7,13). The impact of the decreased sweating ability is also demonstrated by the fact that some patients with GHD are poikilothermic (13).…”

“…In contrast, patients with active acromegaly have thick and greasy skin and the prevalence of excessive sweating in such patients has been reported to be 65±88% (8). Furthermore, the sweat secretion rate (SSR) has been found to be abnormal in both active and inactive acromegaly (4).…”

“…Sweating ability seems to be in¯uenced by sex, age (1) and degree of physical training (2). Patients with childhood onset (CO) growth hormone de®ciency (GHD) have been shown to have impaired sweating ability (1,3) as have men, but not women, with adult onset (AO) GHD (4). The sweating ability has been shown to improve, but not normalise, in patients with CO-GHD when treated with growth hormone (GH) (3).…”