Oral glucose-stimulated growth hormone (GH) test in adult GH deficiency patients and controls: Potential utility of a novel test

Pena-Bello, Lara; Seoane-Pillado, Teresa; Sangiao‐Alvarellos, Susana; Outeiriño-Blanco, Elena; Varela-Rodríguez, Bárbara María; Juiz-Valiña, Paula; Cordido, María; Cordido, Fernando

doi:10.1016/j.ejim.2017.06.004

Cited by 8 publications

(10 citation statements)

References 42 publications

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“…Another potential mechanism may be HbA1c [39], however in the present article we could not find a significant influence of the HbA1c value on the resistance to TH indices. There is an important relationship between the GH-IGF-1 axis and obesity [8][9][10]40], and circulating GH modulates the thyroid axis. Circulating GH levels increased serum FT3 and decreased serum FT4 in humans [41].…”

Section: Discussionmentioning

confidence: 99%

“…Excess body fat is associated with endocrine alterations, including decreased GH secretion [8][9][10] and thyroid dysfunction [10,11]. Thyroid hormone levels have been reported to be normal, increased, and decreased in obese patients; this discrepancy probably reflects the fact that the patients were examined at different times and may differ in degree and type of obesity and metabolic complications [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Central Resistance to Thyroid Hormones in Morbidly Obese Subjects Is Reversed after Bariatric Surgery-Induced Weight Loss

Juiz-Valiña

Cordido

Outeiriño-Blanco

et al. 2020

JCM

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Endocrine abnormalities are common in obesity, including altered thyroid function. The altered thyroid function of obesity may be due to a mild acquired resistance to the thyroid hormone. The aim of this study was to investigate the effect of weight loss after bariatric surgery (BS) on resistance to thyroid hormones in patients with extreme obesity compared with a control group. We performed an observational study evaluating patients with extreme obesity who underwent BS. We included 106 patients (83 women) and 38 controls (24 women). The primary endpoint was the thyrotroph thyroxine resistance index (TT4RI) and thyroid stimulating hormone (TSH) index (TSHRI). The parameters were studied before and after surgery. TSHRI and TT4RI were higher in the obese patients than in the control group. TT4RI and TSHI decreased significantly over time after surgery, with this decrease being associated with the excessive body mass index (BMI) loss and C-reactive protein (CRP). In extreme obesity, BS promotes a significant decrease in the increased TT4RI and TSHI. This decrease of TT4RI and TSHI is progressive over time after BS and significantly associated with excess BMI lost and CRP. Extreme obesity is characterized by a mild reversible central resistance to thyroid hormones.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Central Resistance to Thyroid Hormones in Morbidly Obese Subjects Is Reversed after Bariatric Surgery-Induced Weight Loss

Juiz-Valiña

Cordido

Outeiriño-Blanco

et al. 2020

JCM

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“…Excess body fat is associated with endocrine alterations, including thyroid dysfunction, central resistance to thyroid hormones [ 7 , 8 ] and decreased growth hormone (GH) secretion [ 9 , 10 , 11 ]. The altered GH secretion of obesity can be reversed by body weight normalization [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Altered GH-IGF-1 Axis in Severe Obese Subjects is Reversed after Bariatric Surgery-Induced Weight Loss and Related with Low-Grade Chronic Inflammation

Juiz-Valiña

Pena-Bello

Cordido

et al. 2020

JCM

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Endocrine disorders are common in obesity, including altered somatotropic axis. Obesity is characterized by reduced growth hormone (GH) secretion, although the insulin-like growth factor-1 (IGF-1) values are controversial. The aim of this study was to evaluate the effect of weight loss after bariatric surgery in the GH–IGF-1 axis in extreme obesity, in order to investigate IGF-1 values and the mechanism responsible for the alteration of the GH–IGF-1 axis in obesity. We performed an interventional trial in morbidly obese patients who underwent bariatric surgery. We included 116 patients (97 women) and 41 controls (30 women). The primary endpoint was circulating GH and IGF-1 values. Circulating IGF-1 values were lower in the obese patients than in the controls. Circulating GH and IGF-1 values increased significantly over time after surgery. Post-surgery changes in IGF-1 and GH values were significantly negatively correlated with changes in C-reactive protein (CRP) and free T4 values. After adjusting for preoperative body mass index (BMI), free T4 and CRP in a multivariate model, only CRP was independently associated with IGF-1 values in the follow-up. In summary, severe obesity is characterized by a functional hyposomatotropism at central and peripheral level that is progressively reversible with weight loss, and low-grade chronic inflammation could be the principal mediator.

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“…Adiposity is associated with several endocrine abnormalities, including decreased stimulated growth hormone (GH) secretion [7,8,9] and thyroid dysfunction [9,10]. Thyroid hormone levels have been reported to be normal, increased, and decreased in obese patients; this discrepancy probably reflects the fact that patients were examined at different times and may differ in degree and type of obesity and plasma insulin resistance [10,11,12,13,14,15].…”

Section: Introductionmentioning

confidence: 99%

Effect of Weight Loss after Bariatric Surgery on Thyroid-Stimulating Hormone Levels in Euthyroid Patients with Morbid Obesity

et al. 2019

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Obesity is associated with several endocrine abnormalities, including thyroid dysfunction. The objective of this study was to investigate the effect of weight loss after bariatric surgery on thyroid-stimulating hormone (TSH) levels in euthyroid patients with morbid obesity. We performed an observational study, evaluating patients with morbid obesity submitted to bariatric surgery. We included 129 patients (92 women) and 31 controls (21 women). Clinical, anthropometric, biochemical, and hormonal parameters were evaluated. The primary endpoint was circulating TSH (µU/mL). Fasting TSH levels were higher in the obese group (3.3 ± 0.2) than in the control group (2.1 ± 0.2). The mean excessive body mass index (BMI) loss (EBMIL) 12 months after bariatric surgery was 72.7 ± 2.1%. TSH levels significantly decreased in the obese patients after surgery; 3.3 ± 0.2 vs. 2.1 ± 0.2 before and 12 months after surgery, respectively. Free thyroxine (T4) (ng/dL) levels significantly decreased in the obese patients after surgery; 1.47 ± 0.02 vs. 1.12 ± 0.02 before and 12 months after surgery, respectively. TSH decreased significantly over time, and the decrement was associated with the EBMIL. In euthyroid patients with morbid obesity, weight loss induced by bariatric surgery promotes a significant decline of the increased TSH levels. This decrement of TSH is progressive over time after surgery and significantly associated with excess BMI loss.

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Oral glucose-stimulated growth hormone (GH) test in adult GH deficiency patients and controls: Potential utility of a novel test

Abstract: The LOGT could be a cheap, safe, convenient and effective test for the diagnosis of AGHD.

Cited by 8 publications

References 42 publications

Central Resistance to Thyroid Hormones in Morbidly Obese Subjects Is Reversed after Bariatric Surgery-Induced Weight Loss

Central Resistance to Thyroid Hormones in Morbidly Obese Subjects Is Reversed after Bariatric Surgery-Induced Weight Loss

Altered GH-IGF-1 Axis in Severe Obese Subjects is Reversed after Bariatric Surgery-Induced Weight Loss and Related with Low-Grade Chronic Inflammation

Effect of Weight Loss after Bariatric Surgery on Thyroid-Stimulating Hormone Levels in Euthyroid Patients with Morbid Obesity

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