Premium
SUBCUTANEOUS GROWTH HORMONE‐RELEASING HORMONE AUGMENTS PULSATILE NOCTURNAL GH RELEASE IN GH‐INSUFFICIENT CHILDREN, BUT MAY ALSO RAISE BASAL GH SECRETION
Author(s) -
ROSS R. J. M.,
KIRK J. M. W.,
TSAGARAKIS S.,
TRAINER P. J.,
CICCARELLI E.,
TOUZEL R.,
GROSSMAN A.,
SAVAGE M. O.,
BESSER G. M.
Publication year - 1990
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.1990.tb00488.x
Subject(s) - medicine , endocrinology , basal (medicine) , placebo , pulsatile flow , dose , growth hormone , area under the curve , nocturnal , growth hormone–releasing hormone , hormone , insulin , alternative medicine , pathology
SUMMARY Growth hormone‐releasing hormone (GHRH) when given s. c. to GH‐insufficient children either as pulses, or once or twice daily, promotes linear growth. These treatment regimens, however, are not ideal as they require frequent drug administration and a significant proportion of patients do not show improved growth. We have now investigated the GH response to a nocturnal s. c. infusion of GHRH(1–29)NH 2 , at two dosages, 5 and 10 μg/kg/h, in a group of five GH‐insufficient children. The s. c. infusion of GHRH between 2100 h and 0600 h augmented nocturnal pulsatile GH release in all five children. There was a dose‐dependent response for the GH area under the curve (AUC), and mean total GH concentration. The AUC for GH was significantly greater after the 10 than 5 μg/kg/h GHRH which in turn was greater than that after placebo; mean (SD) AUC: 14816 (3978), 8125 (1931), 3032 (1582) mU min/1 respectively (P < 0.01 and P < 0.05). There was no significant change in the number of GH pulses during the 9‐h infusions when the subjects were infused with GHRH 10 or 5 pg/kg/h compared to placebo, and they occurred at similar times although the number of pulses tended to be greater after GHRH; the mean (SD) numbers of GH pulses were 5.0 (0‐7), 3.8 (0.8), 3.2 (0.8), respectively. There was however a significant rise in the mean baseline GH concentration in all patients during the infusion of GHRH 10 or 5 μg/kg/h compared to placebo, but not with 5 μg/kg/h. Thus, GHRH(1–29)NH 2 given s. c. augmented nocturnal pulsatile GH release in GH‐insufficient children but it also increased baseline GH secretion. These results suggest that a sustained release preparation of GHRH could be a potential treatment for GH‐insufficient children, and that a dose of 5 μg/kg/h would promote pulsatile GH release, but that at higher dosage it may also raise basal GH secretion.