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Somatotropic, Lactotropic and Adrenocortical Responses to Insulin‐Induced Hypoglycemia in Patients with Rheumatoid Arthritis
Author(s) -
ROVENSKY JOZEF,
BAKOŠOVÁ JANA,
KOŠKA JURAJ,
KŠINANTOVÁ LUCIA,
JEŽOVÁ DANIELA,
VIGAŠ MILAN
Publication year - 2002
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.2002.tb04225.x
Subject(s) - medicine , endocrinology , hypoglycemia , prolactin , insulin , basal (medicine) , rheumatoid arthritis , hormone , somatotropic cell , hydrocortisone , hypopituitarism , pituitary gland
A bstract : Neuroendocrine mechanisms have been suggested to play an important role in the onset and progression of rheumatoid arthritis (RA). The aim of this study was to evaluate hypothalamic‐pituitary functions in RA patients by measurement of hormone responses to insulin‐induced hypoglycemia. Insulin‐hypoglycemia (Actrapid HM 0.1 IU/kg, i.v. as a bolus) was induced in 17 male patients and in 11 age‐, gender‐, and weight‐matched healthy subjects. Concentrations of growth hormone (GH), prolactin (PRL) and cortisol were analyzed in plasma. PRL release after thyreoliberin stimulation (TRH, 200 g, i.v.) was determined in 21 patients with active forms of RA and in 12 control subjects to evaluate pituitary lactotropic response. In RA patients, basal concentrations of glucose, GH, PRL, and cortisol were in the normal range and they were comparable to those in the control group. Stress of hypoglycemia induced significant elevation of GH, PRL, and cortisol concentrations in all groups. Cortisol responses to hypoglycemia were comparable in patients and in control subjects. GH release during hypoglycemia was increased ( p < 0.05 ) and PRL response was attenuated ( p < 0.05 ) in RA patients versus control subjects. After TRH administration, PRL response was the same in patients as in healthy subjects. In conclusion, the present study revealed an altered hypothalamic‐pituitary function in patients with RA, namely, an enhanced somatotropic and reduced lactotropic activation in response to insulin‐induced hypoglycemia. Basal hormone levels and cortisol release during hypoglycemia were similar to those in healthy subjects.