Growth hormone secretion in primary adrenal Cushing's syndrome is disorderly and inversely correlated with body mass index

2005 ◽  
Vol 288 (1) ◽  
pp. E63-E70 ◽  
Author(s):  
Maarten O. van Aken ◽  
Alberto M. Pereira ◽  
Marijke Frölich ◽  
Johannes A. Romijn ◽  
Hanno Pijl ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Growth Hormone ◽  
Body Mass ◽  
Approximate Entropy ◽  
Cushing's Syndrome ◽  
Control Group ◽  
Cortisol Secretion ◽  
Age And Gender ◽  
Gh Secretion ◽  
And Gender

To evaluate the impact on the somatotropic axis of endogenous cortisol excess in the absence of primary pituitary disease, we investigated spontaneous 24-h growth hormone (GH) secretion in 12 adult patients with ACTH-independent hypercortisolism. Plasma GH concentration profiles (10-min samples) were analyzed by deconvolution to reconstruct secretion and approximate entropy to quantitate orderliness of the release process. Comparisons were made with a body mass index (BMI)-, age-, and gender-matched control group and an age- and gender-matched lean control group. GH secretion rates did not differ from BMI-matched controls but were twofold lower compared with lean subjects, mainly due to a 2.5-fold attenuation of the mean secretory burst mass ( P = 0.001). In hypercortisolemic patients, GH secretion was negatively correlated with BMI ( R = −0.55, P = 0.005) but not cortisol secretion. Total serum IGF-I concentrations were similar in the three groups. Approximate entropy (ApEn) was increased in patients with Cushing's syndrome compared with both control groups (vs. BMI-matched, P = 0.04; vs. lean, P = 0.001), denoting more irregular GH secretion patterns. ApEn in patients correlated directly with cortisol secretion ( R = 0.77, P = 0.003). Synchrony between cortisol and GH concentration series was analyzed by cross-correlation, cross-ApEn, and copulsatility analyses. Patients showed loss of pattern synchrony compared with BMI-matched controls, but copulsatility was unchanged. We conclude that hyposomatotropism in primary adrenal hypercortisolism is only partly explained (∼30%) by increased body weight and that increased GH secretory irregularity and loss of synchrony suggest altered coordinate regulation of GH release.

scholarly journals Irregular and Frequent Cortisol Secretory Episodes with Preserved Diurnal Rhythmicity in Primary Adrenal Cushing’s Syndrome

2005 ◽  
Vol 90 (3) ◽  
pp. 1570-1577 ◽  
Author(s):  
M. O. van Aken ◽  
A. M Pereira ◽  
S. W. van Thiel ◽  
G. van den Berg ◽  
M. Frölich ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Approximate Entropy ◽  
Cushing's Syndrome ◽  
Cortisol Secretion ◽  
Adrenal Hyperplasia ◽  
Age And Gender ◽  
Pulsatile Secretion ◽  
Event Frequency ◽  
And Gender ◽  
Diurnal Rhythmicity

To evaluate the pathophysiology of altered cortisol secretion in patients with primary adrenal hypercortisolism, cortisol secretion was investigated in 12 patients, seven with a unilateral adenoma and five with ACTH-independent macronodular adrenal hyperplasia compared with age- and gender-matched controls and with patients with pituitary-dependent hypercortisolism. Pulsatile secretion was increased 2-fold (P = 0.04), attributable to increased event frequency (P = 0.002). All patients showed a significant diurnal rhythm with a delay in phase shift of 3 h (P = 0.01). Approximate entropy ratio, a feedback-sensitive measure, was increased compared with controls (P = 0.00003) but similar to that of pituitary-dependent hypercortisolism (P = 0.77), denoting loss of autoregulation. Cortisol burst-mass tended to be smaller in patients with ACTH-independent macronodular adrenal hyperplasia than in unilateral adenoma (P = 0.06). In conclusion, increased cortisol secretion in patients with primary adrenal Cushing’s syndrome is caused by amplified pulsatile secretion via event frequency modulation. We speculate that partial preservation of secretory regularity and diurnal rhythmicity point to incomplete autonomy of these tumors.

Pyridostigmine treatment selectively amplifies the mass of GH secreted per burst without altering GH burst frequency, half-life, basal GH secretion or the orderliness of GH release

1997 ◽  
pp. 377-386 ◽  
Author(s):  
K Friend ◽  
A Iranmanesh ◽  
IS Login ◽  
JD Veldhuis
Keyword(s):  
Body Mass Index ◽  
Growth Hormone ◽  
Body Mass ◽  
Half Life ◽  
Approximate Entropy ◽  
Burst Frequency ◽  
Release Process ◽  
Assay Sensitivity ◽  
Deconvolution Analysis ◽  
Gh Secretion

Growth hormone (GH) release from the anterior pituitary gland is predominantly regulated by the two antagonistic hypothalamic peptides, growth hormone-releasing hormone (GHRH) and somatostatin. Appraising endogenous GHRH action is thus made difficult by the confounding effects of (variable) hypothalamic somatostatin inhibitory tone. Accordingly, to evaluate endogenous GHRH actions, we used a clinical model of presumptively acute endogenous somatostatin withdrawal with concomitant GHRH release. To this end, we administered in randomized order placebo or the indirect cholinergic agonist, pyridostigmine, for 48 h to 13 healthy men of varying ages (29-77 years) and body mass indices (21-47 kg/m2). We sampled blood at 10-min intervals for 48 h during both placebo and pyridostigmine (60 mg orally every 6 h) administration, and used an ultrasensitive GH chemiluminescence assay (sensitivity 0.0002-0.005 microgram/l) to capture GH pulse profiles. Multiparameter deconvolution analysis was applied to quantitate the number, amplitude, mass, and duration of significant underlying GH secretory bursts, and simultaneously estimate the GH half-life and concurrent basal GH secretion. Approximate entropy was utilized as a novel regularity statistic to quantify the relative orderliness of the hormone release process. All measures of GH secretion/half-life and orderliness were statistically invariant across the two consecutive 24-h placebo sessions. In contrast, pyridostigmine treatment significantly increased the mean serum GH concentration from 0.23 +/- 0.054 microgram/l during placebo to 0.45 +/- 0.072 microgram/l during the first day of treatment (P < 0.01). There was also a significant rise in the calculated 24-h pulsatile GH production rate from 8.9 +/- 1.7 micrograms/l/day on placebo to 27 +/- 5.6 micrograms/l/day during active drug treatment (P < 0.01). Pyridostigmine significantly and selectively amplified GH secretory burst mass to 1.5 +/- 0.35 micrograms/l compared with 0.74 +/- 0.19 microgram/l on placebo (P < 0.01). This was attributable to stimulation of GH secretory burst amplitude (maximal rate of GH secretion attained within the release episode) with no prolongation of estimated burst duration. Basal GH secretion and approximate entropy were not altered by pyridostigmine. However, age was strongly related to more disorderly GH release during both days of pyridostigmine treatment (r = +0.79, P = 0.0013). During the second 24-h of continued pyridostigmine treatment, most GH secretory parameters decreased by 15-50%, but in several instances remained significantly elevated above placebo. Body mass index, but not age, was a significantly negative correlate of the pyridostigmine-stimulated increase in GH secretion (r = -0.65, P = 0.017). In summary, assuming that somatostatin is withdrawn and (rebound) GHRH release is stimulated via pyridostigmine administration, we infer that relatively unopposed GHRH action principally controls GH secretory burst mass and amplitude, rather than apparent GH secretory pulse duration, the basal GH secretion rate, or the serial regularity/orderliness of the GH release process in the human. Moreover, we infer that increasing age is accompanied by greater disorderliness of somatostatin-withdrawn GHRH, and hence rebound GH, release. The strongly negative correlation between pyridostigmine-stimulated GH secretion and body mass index (but not age) further indicates that increased relative adiposity may result in decreased effective (somatostatin-withdrawn) endogenous GHRH stimulus strength.

scholarly journals Body Mass Index and Helicobacter pylori among Obese and Non-Obese Patients in Najran, Saudi Arabia: A Case-Control Study

2018 ◽  
Vol 15 (11) ◽  
pp. 2586 ◽  
Author(s):  
Ali Al-Zubaidi ◽  
Abdo Alzobydi ◽  
Saeed Alsareii ◽  
AbdulazizTurky Al-Shahrani ◽  
Naweed Alzaman ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Helicobacter Pylori ◽  
Saudi Arabia ◽  
Body Mass ◽  
Upper Endoscopy ◽  
Obese Patients ◽  
Age And Gender ◽  
Total Prevalence ◽  
And Gender ◽  
Saudi Patients

Objective: We examine obese and non-obese patients with respect to Helicobacter pylori (H. pylori) positive-infection (HPPI) and associated factors, specifically body mass index (BMI). Methods: This study took place in the Department of Endoscopy of a central hospital in the Najran region of Saudi Arabia (SA). A total of 340 obese Saudi patients (BMI ≥ 30 kg/m2) who had undergone diagnostic upper endoscopy before sleeve gastrectomy, were compared with 340 age and gender-matched control patients (BMI < 30 kg/m2) who had undergone diagnostic upper endoscopy for other reasons. Data collected included diagnosis of HPPI. Descriptive and multivariable binary logistic regression was conducted. Results: Mean patient age was 31.22 ± 8.10 years, and 65% were males. The total prevalence of HPPI was 58% (95% CI = 54–61%) with obese patients presenting significantly more HPPI than non-obese patients (66% vs. 50%, OR = 1.98, 95% CI = 1.45–2.70, p < 0.0005). Age and gender did not associate significantly with HPPI (p = 0.659, 0.200, respectively) and increases in BMI associated significantly with increases in HPPI (p < 0.0005). BMI remained a significant factor in HPPI when modelled with both age and gender (OR = 1.022, 95% CI = 1.01–1.03, p < 0.0005). Conclusions: Within the limitations of this study, the significance of HPPI in obese Saudi patients residing in the Najran region in SA was demonstrated alongside the significance role of BMI in HPPI.

Percentile Charts for Body Mass Index of Indian Down Syndrome Children

2021 ◽  
Author(s):  
Harvinder Kaur ◽  
Anil Kumar Bhalla ◽  
Inusha Panigrahi
Keyword(s):  
Body Mass Index ◽  
Down Syndrome ◽  
Body Mass ◽  
Overweight And Obesity ◽  
World Health ◽  
Growth Charts ◽  
Indian Children ◽  
Age And Gender ◽  
And Gender ◽  
Gender Specific

AbstractGrowth charts are used to detect growth impairment, overweight, and obesity among Down syndrome (DS) children belonging to different population groups. Due to nonavailability of similar information, age, and gender specific body mass index (BMI) charts for DS children of Indian origin, based on serial data, have been developed. A total of 752 boys and 373 girls diagnosed as cases of DS at <1 month to 10 years of age enrolled from the “genetic clinic” were followed up in the “growth clinic/growth laboratory” of the institute, following a mixed-longitudinal growth research design. BMI was calculated from body weight and length/height measured at 6-month-age intervals by using standardized techniques and instruments. Age and sex-specific percentile growth charts for BMI were generated for age range <1 month to 10 years by using the LMS method. DS children remained wasted (BMI <3rd percentile) up to 6 months of age; thereafter, BMI increased to exhibit close similarity with their normal Multicentre Growth Reference Study (World Health Organization 2006) and Indian Academy of Pediatrics (2015) counterparts up to 5 to 10 years, respectively. The percentage of obese DS girls (8.76%) outnumbered boys with DS (4.1%). The use of age and gender specific BMI growth charts may be made for comparative purpose, to assess nutritional status of Indian children with DS, to initiate suitable need-based intervention to improve their overall health and for timely institution of target interventions to prevent growth faltering in this vulnerable population.

Changes regarding Age and Correlations between Serum Lipids and Body Mass Index in Humankind

2002 ◽  
Vol 41 (03) ◽  
pp. 202-208 ◽  
Author(s):  
I. Yamasawa ◽  
S. Kamohara ◽  
M. Shiota ◽  
T. Komori ◽  
Y. Watanabe ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Serum Lipids ◽  
Density Lipoprotein ◽  
Atherogenic Index ◽  
Health Examination ◽  
Age And Gender ◽  
Gender And Age ◽  
Specialized Care ◽  
And Gender

Summary Objectives: To improve insight into age and gender related distributions of serum lipids and their correlation with body mass index (BMI). Methods: Serum lipids embracing atherogenic index (AI) and BMI were analyzed from the results obtained in 19,823 men and 14,788 women undergoing a health examination between 1986 and 1996. Results: The changes in total cholesterol (TC), triglyceride (TG), AI and BMI differed regarding gender. Although high-density lipoprotein-cholesterol (HDL-C) showed a flat pattern for all ages in both genders, its level in women was higher than in men. The ratio of the number in the unsuitable range to those in the suitable range increased with age as to TC in both sexes, then more than half of the population have an unsuitable level in the sixth decade. As for the correlation between serum lipids and BMI: TC, TG and AI correlated positively, but HDL-C correlated negatively. There were significant gaps between both age and gender. Conclusions: We suggest that the normal range of values of serum lipids needs to be revised according to gender and age to evaluate the risk status for a cardio-cerebrovascular disease more precisely in the field of preventive medicine. Simpler guidelines are preferable in specialized care as well as in general practice, particularly since computer technology is not yet universally adapted. In the near future, when computed information technology will be as common as the electricity and the telephone are current on the whole earth, all guidelines will have to be computed on the spot and personally.

scholarly journals Child Nutritional Status—Alternative Metrics to Body Mass Index

Proceedings ◽  
2019 ◽  
Vol 8 (1) ◽  
pp. 33
Author(s):  
E. Rush ◽  
L. Young ◽  
C. Cairncross
Keyword(s):  
Body Mass Index ◽  
Nutritional Status ◽  
Body Mass ◽  
Age And Gender ◽  
Relative Growth ◽  
Under Nutrition ◽  
And Gender ◽  
Child Nutritional Status ◽  
Alternative Metrics

Background: For children, body mass index, adjusted for age and gender is the globally acceptedmeasure of relative growth and risk of over and under-nutrition [...]

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