Nocturnal growth hormone and gonadotrophin secretion in growth retarded children with Crohn's disease.

Abstract

SUMMARY Although impaired growth hormone secretion in response to pharmacological stimuli occurs in some growth retarded children with Crohn's disease, its relationship to past and future th is uncertain. We have therefore determined the grpppppwth hormone and gonadotrophin response to the physiological stimulus of sleep by continuous venous sampling in five severely growth is uncertain. We have therefore determined the growth hormone and gonadotrophin gonadotrophin profiles, the mean plasma hormone concentrations during the first five hours of sleep were determined. In three of the five patients, five hour mean growth hormone levels were reduced (3 8, 5 0, and 8&5 mU/l) compared with levels reported previously in normal short children (10-43 mU/l), although the pulsatile pattern of growth hormone secretion was preserved in all. Nocturnal growth hormone secretion was unrelated to the growth velocities of these children during both pre-and post-treatment assessment periods but a significant correlation was found between growth hormone concentration and a disease activity score (r = 0-79, P <0-05), suggesting that growth hormone release by the pituitary was influenced by the severity of the disease. Nocturnal growth hormone secretion was also correlated with gonadotrophin secretion (luteinising hormone, r=0 99, and follicle stimulating hormone, r=0-96; P<0.01) indicating more extensive hypothalamic-pituitary disturbance. These findings suggest that hypothalamic-pituitary function is depressed in growth retarded children with Crohn's disease, but that abnormalities of growth hormone secretion are unlikely to be directly involved in the growth retardation seen in this condition.

Crohn's Disease Associated with Growth Hormone Secretory Dysfunction.

“…These findings are compatible with those of Farthing et al (19), which suggest that Crohn's disease is accompaniedby GH system abnormalities in the hypothalamus. The etiology of Crohn's disease remains unclear.…”

Infliximab reverses growth hormone resistance associated with inflammatory bowel disease

“…Other studies in IBD patients have demonstrated normal, reduced, or even elevated GH levels in these patients. 18,29,30 Interestingly, in our study population, GH/IGF-1 axis derangement occurs in patients presenting a satisfactory nutritional status, comparable with that in controls, thus suggesting a predominant role of systemic inflammation rather than a reduced proteincalorie intake. During induction treatment with infliximab, IGF-1 and IGFBP-3 levels increased significantly with respect to baseline, and IGF-1 reached values comparable with those in healthy controls.…”

Puberty in Chronically Diseased Patients

“…These abnormalities are partially restored after kidney transplantation. Changes in GH and gonadotrophin secretion have also been reported in patients with Crohn’s disease [15]and cystic fibrosis [16]. …”