The effect of long-term pulsatile GnRH administration on the 24-hour integrated concentration of GH in hypogonadotropic hypogonadic patients

Giusti, Massimo; Torre, R. La; Cavagnaro, P.; Attanasio, Roberto; Traverso, Laura; Giordano, G

doi:10.1530/acta.0.1200724

Cited by 9 publications

(5 citation statements)

References 12 publications

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“…In addition, we found a decline directly after menarche, which has not previously been reported. The increase is mainly the result of an increased GH pulse amplitude as it is in boys (11,(21)(22)(23). Mean GH level and the fraction of GH in pulses increase 2-3 fold during this pubertal period.…”

Section: Discussionmentioning

confidence: 91%

“…Estrogens have been implicated to increase spontaneous secretion of GH as well as secretion in response to provoca¬ tive stimuli (6)(7)(8)(9). Furthermore, during GnRH-in¬ duced puberty, a concurrent increase in GH secre¬ tion was reported in hypogonadotropic female patients (10,11). Therefore, stimulation of the go¬ nadal axis seems to result in an increased GH se¬ cretion.…”

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confidence: 99%

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Growth hormone secretion patterns in relation to LH and estradiol secretion throughout normal female puberty

Wennink

Waal

Schoemaker

et al. 1991

Acta Endocrinologica

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Pulsatile growth hormone secretion patterns were studied in relation to luteinizing hormone and estradiol release in 33 healthy (pre)pubertal girls. Plasma GH was determined every 10 min, plasma LH and E2 every hour. Night-time GH release was always higher than daytime GH release. During daytime, all GH secretion parameters, except for the basal GH level, increased significantly from the prepubertal stage to stage B4 before (m\m=-\) the menarche (p=0.05) and decreased thereafter (p=0.05). During night-time, mean GH level and the fraction of GH in pulses also tended to increase from stage B1 to stage B4m\m=-\.The number of high pulses (>8 \g=m\g/l )during day and night together tended to increase until stage B4m\m=-\and decreased after the menarche (p=0.05). Height velocity did not correlate with the number of high pulses (Kendall \g=t\=0.14,p=0.14). From stage B1 to B4m\m=-\ high correlations were observed between E2 levels and GH secretion parameters, particularly during the day (\g=t\=0.59-0.71,p\m=le\0.01).The correlations between LH levels and GH secretion were high as well (\g=t\=0.50-0.81, p\m=le\0.01), but equal during day and night. It is concluded that during puberty 1. spontaneous GH release in girls increases 2-3 fold until the menarche and decreases thereafter, primarily as the result of an increasing and decreasing GH pulse amplitude; 2. diurnally increasing estradiol levels correlated with increasing GH secretion.Studies of spontaneous growth hormone secretion in girls during puberty have revealed either no change (1-3) or an increase (4,5). Estrogens have been implicated to increase spontaneous secretion of GH as well as secretion in response to provoca¬ tive stimuli (6-9). Furthermore, during GnRH-in¬ duced puberty, a concurrent increase in GH secre¬ tion was reported in hypogonadotropic female patients (10,11). Therefore, stimulation of the go¬ nadal axis seems to result in an increased GH se¬ cretion. Different assay methods, detecting GH at various degrees, and investigations in groups of se¬ lected children, such as those with short stature, may have contributed to the initial discrepancies.To further elucidate GH release in girls during spontaneous pubertal development, we investi¬ gated 33 healthy girls at different pubertal stages with a novel, sensitive and accurate oligoclonal immunoradiometric assay (IRMA) for GH. This oli¬ goclonal IRMA has the advantage of measuring high values of GH, especially in the higher range concentrations (12) resulting in a more pro¬ nounced pulsatile pattern. Moreover, the results are intimately related to those of the NB2-lymphocyte GH bioassay (13).The basic question addressed here is how spon¬ taneous GH secretory profiles change in girls during daytime and night-time with the onset and advancement of puberty, as well as in relation to physiological changes in LH and estradiol (E2) se¬ cretion. In addition, the relationship to growth during puberty is investigated.

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Section: Discussionmentioning

confidence: 91%

mentioning

confidence: 99%

Growth hormone secretion patterns in relation to LH and estradiol secretion throughout normal female puberty

Wennink

Waal

Schoemaker

et al. 1991

Acta Endocrinologica

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“…Several studies have shown that in men, regardless of age, testosterone centrally increases the GH level, followed by IGF-I production through the push effect. 36 – 40 Studies were performed to determine whether testosterone enhances IGF-I directly or as a costimulatory factor to GH; testosterone alone had a very limited or no effect on circulating IGF-I levels except in the presence of GH. 41 – 43 On the contrary, there is a debate concerning the relationship between estrogen and GH/IGF-I.…”

Section: Factors Affecting Plasma Levels Of Gh/igf-imentioning

confidence: 99%

Type I insulin-like growth factor as a liver reserve assessment tool in hepatocellular carcinoma

Abdel-Wahab

Shehata

Hassan

et al. 2015

JHC

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Chronic liver diseases (CLDs) encompass a wide range of illnesses, including nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, and viral hepatitis. Deterioration of liver capacity, with subsequent progression into cirrhosis and hepatocellular carcinoma (HCC), ultimately leads to a further decrease in the hepatic reserve. The Child–Turcotte–Pugh scoring system is the standard tool for assessing underlying liver reserve capacity in routine practice and in clinical trials of CLD and HCC. In this review, we highlight the clinical significance of insulin-like growth factor-I (IGF-I) and the growth hormone (GH) signaling pathway in HCC. IGF-I could be a marker for liver reserve capacity in CLDs and HCC in clinical practice. This approach could improve the risk assessment and stratifications of patients on the basis of their underlying liver reserve, either before active treatment in routine practice or before they are enrolled in clinical trials.

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“…In adults, the relationships between gonadal and GH status are strong for men but appear less so for women. GH secretion is reduced in men with hypogonadism regardless of cause and is normalized by androgen replacement or by pulsatile GnRH treatment in those with hypogonadotrophic hypogonadism 17–20 . In women the relationship between oestrogen and GH levels is inconsistent.…”

Section: Neurosecretory Modulationmentioning

confidence: 99%

“…In pre‐ and peripubertal boys, testosterone in physiological and pharmacological doses increases spontaneous and stimulated GH secretion 12,24,25 . In hypogonadal and elderly men, testosterone and GnRH treatment, respectively, increase spontaneous and stimulated GH secretion 17–20,26,27 . The stimulatory action of testosterone on the GH axis appears to be mediated at the hypothalamic level by GHRH 19 .…”

Section: Neurosecretory Modulationmentioning

confidence: 99%

Modulation of growth hormone action by sex steroids

Meinhardt

2006

Clinical Endocrinology

189

122

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SummaryGrowth hormone (GH) is a major regulator of growth, somatic development and body composition. Sex steroids can act centrally by regulating GH secretion and peripherally modulating GH responsiveness. This review addresses data of potential clinical relevance on how sex steroids modulate GH secretion and action, aiming to increase the understanding of sex steroid/GH interactions and leading to improved management of patients. Sex steroids regulate GH secretion directly as well as indirectly through IGF-I modulation. Testosterone stimulates GH secretion centrally, an effect dependent on prior aromatization to oestrogen. Oestrogen stimulates GH secretion indirectly by reducing IGF-I feedback inhibition. Whether oestrogen stimulates GH secretion centrally in females is unresolved.Gonadal steroids modify the metabolic effects of GH. Testosterone amplifies GH stimulation of IGF-I, sodium retention, substrate metabolism and protein anabolism while exhibiting similar but independent actions of its own. Oestrogen attenuates GH action by inhibiting GH-regulated endocrine function of the liver. This is a concentration-dependent phenomenon that arises invariably from oral administration of therapeutic doses of oestrogen, an effect that can be avoided by using a parenteral route.This strong modulatory effect of gonadal steroids on GH responsiveness provides insights into the biological basis of sexual dimorphism in growth, development and body composition and practical information for the clinical endocrinologist. It calls for an appraisal of the diagnostic criteria for GH deficiency of GH stimulation tests, which currently are based on arbitrary cut-offs that do not take into account the shifting baseline from the changing gonadal steroid milieu. In the management of GH deficiency in the hypopituitary female, oestrogen should be administered by a nonoral route. In hypopituitary men, androgens should be replaced concurrently to maximize the benefits of GH. In the general population, the metabolic consequences of long-term treatment of women with oral oestrogen compounds, including selective oestrogen receptor modulators, are largely unknown and warrant study.

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The effect of long-term pulsatile GnRH administration on the 24-hour integrated concentration of GH in hypogonadotropic hypogonadic patients

Cited by 9 publications

References 12 publications

Growth hormone secretion patterns in relation to LH and estradiol secretion throughout normal female puberty

Growth hormone secretion patterns in relation to LH and estradiol secretion throughout normal female puberty

Type I insulin-like growth factor as a liver reserve assessment tool in hepatocellular carcinoma

Modulation of growth hormone action by sex steroids

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