Influence of gender, age, body mass index, abdominal fat and serum levels (HDL-C, glucose, triglycerides, IGF-1) on growth hormone (GH) response to GH-releasing hormone plus arginine and insulin tolerance tests / Einfluss von Geschlecht, Lebensalter, BMI, Bauchumfang und laborchemischen Parametern (HDL-C, Glukose, Triglyzeride, IGF-1) auf den Wachstumshormon-Anstieg nach der Durchführung eines GHRH+Arginin- und eines Insulin-Toleranz-Tests

2010 ◽  
Vol 34 (1) ◽  
pp. 45-51
Author(s):  
Eva Fedeler ◽  
Elisabeth Spilcke-Liss ◽  
Henry W.S. Schroeder ◽  
Markus M. Lerch ◽  
Matthias Nauck ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Growth Hormone ◽  
Negative Correlation ◽  
Gh Deficiency ◽  
Significant Negative Correlation ◽  
Abdominal Circumference ◽  
Insulin Tolerance ◽  
Igf I ◽  
Group 2 ◽  
Group 1

AbstractBackground: Diagnosis of growth hormone (GH) deficiency in adulthood is established by provocative testing of GH secretion. The insulin tolerance test (ITT) is recommended as the gold standard, whereas the combined GH-releasing hormone (GHRH) plus arginine (GHRH+ARG) test is considered the best alternative to the ITT. The aim of the present study was to correlate the degree of the GH response to the GHRH+ARG test and to the ITT and to assess the influence of gender, age, body mass index (BMI), abdominal circumference, high-density lipoprotein cholesterol (HDL-C), triglycerides, serum glucose and insulin-like growth factor 1 (IGF-1) to the GH response.Methods: A total of 50 adult patients (25 men, 25 women) aged 18–74 years were studied. BMI and abdominal circumference were measured. Basal blood samples were taken for IGF-1, HDL, glucose and triglycerides. All subjects underwent GH provocation with both the GHRH+ARG test and the ITT.Results: Peak GH response was significantly higher (men/women: p<0.01) after GHRH+ARG than with ITT, with a strong positive correlation between the peak GH responses in both tests (r=0.753, p<0.01). Peak GH response to ITT and to GHRH+ARG was significantly higher in females than in males (ITT, p=0.01; GHRH+ARG, p<0.01). A significant negative correlation was found between the peak GH response after ITT and GHRH+ARG and age (ITT, r=−0.322; GHRH+ARG, r=−0.281). There was also a significant negative correlation between peak GH response to GHRH+ARG and BMI (r=−0.332) and abdominal circumference (r=−0.388). Peak GH response was positively correlated with plasma IGF-I levels in both tests (ITT, r=0.437; GHRH+ARG, r=0.346). On the basis of the GH response to both GH provocation tests, the subjects were divided into two groups: group 1, subjects with severe GH deficiency (23 patients with GH peak ≤3 μg/L in ITT and ≤9 μg/L in GHRH+ARG); group 2, subjects with slight or without GH deficiency (27 subjects with GH peak >3 μg/L in ITT and >9 μg/L in GHRH+ARG). In group 1 patients, plasma IGF-I concentrations were lower than in group 2 (p=0.019) and there were significantly older (p=0.042) and more male (p=0.0041) patients in group 1. No significant difference was found for BMI, abdominal circumference, HDL, glucose and triglyceride levels between the two groups.Conclusions: The results of the present study indicate that the degree of the GH response to ITT and GHRH+ARG is correlated with age and plasma IGF-I levels. There is a correlation between peak GH after GHRH+ARG and BMI as well as abdominal circumference. Therefore, age-, gender- and BMI-related test specific cut-off points are required.

GROWTH AND GROWTH HORMONE. IV. LIMITATIONS OF THE GROWTH HORMONE RESPONSE TO INSULIN AND ARGININE AND OF THE IMMUNOREACTIVE INSULIN RESPONSE TO ARGININE IN THE ASSESSMENT OF GROWTH HORMONE DEFICIENCY IN CHILDREN

PEDIATRICS ◽  
1969 ◽  
Vol 43 (6) ◽  
pp. 989-1004
Author(s):  
R. Youlton ◽  
S. L. Kaplan ◽  
M. M. Grumbach
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Gh Deficiency ◽  
Hormone Deficiency ◽  
Insulin Administration ◽  
Arginine Infusion ◽  
Group 3 ◽  
Group 2 ◽  
Serum Gh ◽  
Group 1

The growth hormone (GH) response to insulin-induced hypoglycemia and to arginine infusion has been evaluated in 60 children with growth retardation. These children have been classified into three groups: Group 1-9 children had peak serum growth hormone values of 7 mµg/ml or greater to both stimuli, a normal growth hormone response. Group 2-18 children had peak GH values of ≤ 3 mµg/ml to both stimuli, an abnormal response indicating growth hormone deficiency. Group 3-6 children had a blunted GH response (&gt; 3 &lt; 7 mµg/ml) to both stimuli; 8 showed a normal rise in serum GH following arginine infusion (&gt; 7 mµg/ml) but exhibited no rise, or a minimal one, following insulin administration; 9 children had minimal increase in serum GH concentration following arginine infusion but showed a normal GH response to insulin administration (&gt; 7mµg/ml). Children included in Group 3 represent a heterogenous population. In some patients with a blunted response to both stimuli, evidence of partial or less severe form of GH deficiency was found, whereas in 17 of 18 children exhibiting a disparate response the impaired growth was not attributable to growth hormone deficiency. The blood glucose at all sampling periods was significantly lower following insulin administration in patients in Group 2 than that observed for children in Group 1 and 3. The blood glucose was significantly lower at 90 and 120 minutes following arginine infusion in Group 2 compared to values for patients in Group 1 and 3. Changes in serum insulin in response to the infusion of arginine did not provide a useful index of discrimination among these groups. Administration of diethylstilbestrol, 10 mg/day times 2 days, prior to testing can modify the GH response to both hypoglycemia and arginine; it is a useful ancillary procedure in children with blunted or disparate responses. These studies suggest that two types of stimulation tests are necessary to establish the diagnosis of isolated GH deficiency with a high degree of probability.

scholarly journals Comparison of Olfactory Cleft Width and Volumes in Patients with COVID-19 Anosmia and COVID-19 Cases Without Anosmia

ORL ◽  
2021 ◽  
pp. 1-9
Author(s):  
Deniz Esin Tekcan Sanli ◽  
Aytug Altundag ◽  
Duzgun Yıldırım ◽  
Sedat Giray Kandemirli ◽  
Ahmet Necati Sanli
Keyword(s):  
Negative Correlation ◽  
Test Scores ◽  
Significant Negative Correlation ◽  
Olfactory Dysfunction ◽  
Olfactory Cleft ◽  
Identification Test ◽  
Group 2 ◽  
The Relationship ◽  
Tdi Score ◽  
Group 1

<b><i>Introduction:</i></b> The aim of this study was to assess the relationship between olfactory cleft width/volume and COVID-19-related anosmia. <b><i>Methods:</i></b> This study consisted of PCR-proven COVID-19 patients. Cases with COVID-19-related anosmia constituted Group 1 and cases without any olfactory dysfunction (OD) throughout COVID-19 infection or after recovery constituted Group 2. A total of 50 patients were included in the study, comprising 24 cases in Group 1 and 26 cases in Group 2. Group 1 patients underwent a 4-item-odor identification test during active symptoms and a Sniffin’ Sticks test after reconversion of PCR results to negative. All patients in Group 2 also underwent the Sniffin’ Stick test to document normosmia. All cases had paranasal sinus CT performed. Olfactory cleft widths and olfactory volumes were measured. The differences in width and volume between groups and the correlation with odor test scores (threshold-discrimination-identification [TDI]) were calculated. In addition, regression analyzes analysis was performed for cleft widths, volumes, and TDI scores according to age. <b><i>Results:</i></b> Olfactory cleft widths and olfactory volumes were significantly higher in Group 1 than those in Group 2 (<i>p</i> = 0.001; <i>p</i> &#x3c; 0.01). There was a significant negative correlation between total TDI scores and olfactory cleft widths and total olfactory volumes (<i>r</i> = −0.665; <i>r</i> = −0.731, respectively). Patients younger than 40 years of age had significantly higher right olfactory cleft width, left olfactory cleft width, and olfactory cleft volume than those in patients older than 40 years of age (<i>p</i> = 0.004, <i>p</i> = 0.005, <i>p</i> = 0.003; <i>p</i> &#x3c; 0,01, respectively). However, patients younger than 40 years of age had a significantly lower total TDI score and in all other values individually (t-d-i) than those in patients older than 40 years of age (<i>p</i> = 0.004; <i>p</i> &#x3c; 0.01). <b><i>Conclusion:</i></b> Patients with COVID-19-related OD had larger olfactory cleft width and volumes than those without OD in this study. Total TDI score was found to be inversely correlated with cleft width and volume.

scholarly journals The exon 3-deleted/full-length Growth Hormone Receptor Polymorphism Does Not Influence the Effect of Puberty or Growth Hormone Therapy on Glucose Homeostasis in Short Non-Growth Hormone-Deficient Small-for-Gestational-Age Children: Results from a Two-Year Controlled Prospective Study

2008 ◽  
Vol 93 (7) ◽  
pp. 2709-2715 ◽  
Author(s):  
L. Audí ◽  
A. Carrascosa ◽  
C. Esteban ◽  
M. Fernández-Cancio ◽  
P. Andaluz ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Growth Hormone ◽  
Insulin Sensitivity ◽  
Glucose Homeostasis ◽  
Fasting Glucose ◽  
Gh Therapy ◽  
Group 3 ◽  
Group 2 ◽  
Receptor Polymorphism ◽  
Group 1

Abstract Context: The exon 3-deleted/full-length (d3/fl) GH receptor polymorphism (d3/fl-GHR) has been associated with responsiveness to GH therapy in short small-for-gestational-age (SGA) patients, although consensus is lacking. However, its influence on glucose homeostasis, at baseline or under GH therapy, has not been investigated. Objective: Our objective was to evaluate whether the d3/fl-GHR genotypes influence insulin sensitivity in short SGA children before or after puberty onset or during GH therapy. Design: We conducted a 2-yr prospective, controlled, randomized trial. Setting: Thirty Spanish hospitals participated. Auxological, GH secretion, and glucose homeostasis evaluation was hospital based, whereas molecular analyses and data computation were centralized. Patients: Patients included 219 short SGA children [body mass index sd score (SDS) ≤ 2.0]; 159 were prepubertal (group 1), and 60 had entered puberty (group 2). Intervention: Seventy-eight patients from group 1 were treated with GH (66 μg/kg·d) for 2 yr (group 3). Main Outcome Measures: Previous and 2-yr follow-up auxological and biochemical data were recorded, d3/fl-GHR genotypes determined, and data analyzed. Results: In groups 1 and 2, fasting glucose, insulin, homeostasis model assessment (HOMA), and quantitative insulin sensitivity check index (QUICKI) were similar in each d3/fl-GHR genotype. Group 2 glucose, insulin, and HOMA were significantly higher and QUICKI lower than in group 1. In group 3 GH-treated patients, height SDS, growth velocity SDS, fasting glucose, insulin, and HOMA significantly increased as did body mass index SDS at the end of the second year, and QUICKI decreased during the first and second years, with no differences among the d3/fl-GHR genotypes. Conclusion: In short SGA patients, the d3/fl-GHR genotypes do not seem to influence prepubertal or pubertal insulin sensitivity indexes or their changes over 2 yr of GH therapy (66 μg/kg·d).

scholarly journals New insights into vitamin D regulation: is there a role for alkaline phosphatase?

2021 ◽  
Author(s):  
G. Bellastella ◽  
L. Scappaticcio ◽  
M. Longo ◽  
R. Carotenuto ◽  
C. Carbone ◽  
...  
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Liver Function ◽  
Significant Negative Correlation ◽  
Liver Function Tests ◽  
Bone Alkaline Phosphatase ◽  
Gamma Glutamyl Transpeptidase ◽  
Function Tests ◽  
Group 2 ◽  
Group 1

Abstract Purpose The diagnosis of vitamin D deficiency is based on the determination of total plasma 25-hydroxyvitamin D (25-OHD) concentrations, but the regulation of vitamin D 25-hydroxylation is not a major consideration and very little information is available on this activity. To check what factors could interfere with the activity of vitamin D-25-hydroxylase and thus alter the 25-OHD concentrations, we looked for potential correlations between 25-OHD and results of liver function tests in healthy adults. Methods This single-centre study was retrospective and consisted of evaluating the correlations between 25-OHD and the activities of aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), and bone alkaline phosphatase (BALP) in 349 healthy subjects aged from 18 to 65 years. In particular, in Group 1 (n = 119), we looked for correlations between 25OHD and all liver function tests and in Group 2 (n = 230) the correlation between 25OHD and BALP. Results In Group 1, we found no correlation between 25OHD and AST (r =  − 0.03; p = 0.8), ALT (r =  − 0.02; p = 0.91), GGT (r =  − 0.08; p = 0.68), direct bilirubin (r =  − 0.02; p = 0.89), indirect bilirubin (r =  − 0.24; p = 0.21), and total bilirubin (r =  − 0.24; p = 0.21) but one between 25OHD and ALP (r =  − 0.2; p = 0.007); in Group 2, we found a significant negative correlation between 25-OHD and BALP (r =  − 0.2; p = 0.0008). Conclusions The correlations that we found suggest that ALP and BALP might be involved in the regulation of vitamin D-25-hydroxylase activity, but further studies are mandatory to confirm our assumptions.

scholarly journals Utility of P300 auditory event related potential latency in detecting cognitive dysfunction in growth hormone (GH) deficient patients with Sheehan's syndrome and effects of GH replacement therapy

2004 ◽  
pp. 153-159 ◽  
Author(s):  
A Golgeli ◽  
F Tanriverdi ◽  
C Suer ◽  
C Gokce ◽  
C Ozesmi ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Cognitive Function ◽  
Replacement Therapy ◽  
Patient Group ◽  
Gh Deficiency ◽  
Event Related Potential ◽  
Sheehan’S Syndrome ◽  
Gh Replacement ◽  
Igf I ◽  
Sheehan's Syndrome

OBJECTIVE: Impaired cognitive function has been demonstrated in adults with growth hormone (GH) deficiency (GHD) by using different neuropsychological tests. Despite several studies, present knowledge about the impact of GHD and GH replacement therapy (GHRT) on cognitive function is limited. P300 event-related potential (ERP) application is a well-established neurophysiological approach in the assessment of cognitive functions including the updating of working memory content and the speed of stimulus evaluation. GHD is a well-known feature of Sheehan's syndrome and cognitive changes due to GHD and the effects of GHRT remain to be clarified. The present study was designed to investigate the effects of GHD and 6 months of GHRT on cognitive function in patients with Sheehan's syndrome by using P300 latency. DESIGN AND METHODS: The study comprised 14 patients with Sheehan's syndrome (mean age, 49.5+/-7.8 years) and 10 age-, education- and sex-matched healthy controls. With hormone replacement therapy, basal hormone levels other than GH were stable before enrollment and throughout the GHRT. The diagnosis of GH deficiency was established by insulin-tolerance test (ITT), and mean peak level of GH in response to insulin hypoglycemia was 0.77+/-0.35 mIU/l. Treatment with GH was started at a dose of 0.45 IU (0.15 mg)/day in month 1, was increased to 0.9 IU (0.30 mg)/day in month 2 and was maintained at 2 IU (0.66 mg)/day. Initially baseline auditory ERPs in patients and controls were recorded at frontal (Fz), central (Cz), and parietal (P3 and P4) electrode sites. In the patient group, ERPs were re-evaluated after 6 months of GH replacement therapy. During each session P300 amplitude and latency were measured. RESULTS: Mean serum insulin-like growth factor-I (IGF-I) concentration in the patient group before GHRT was 23+/-13 ng/ml. After 6 months of GH therapy mean IGF-I significantly increased to an acceptable level, 234+/-71 ng/ml (P<0.05). The mean latencies (at all electrode sites) of the patients before GHRT were found to be significantly prolonged when compared with those of normal controls (P<0.05). After 6 months of GHRT mean P300 latencies (at all electrode sites) were decreased significantly when compared with latencies before treatment (P<0.05). CONCLUSIONS: The present study, using P300 ERP latencies, therefore suggests an impairment of cognitive abilities due to severe GHD in patients with Sheehan's syndrome and an improvement of cognitive function after 6 months of physiological GHRT. Moreover, this was a novel application of P300 ERP latencies in cognitive function detection in patients with GHD. Further studies with different patient groups need to be done to assess the clinical use of this electrophysiological method in the diagnosis of cognitive dysfunction due to GHD.

scholarly journals When to resume bariatric surgery after COVID-19 pandemic?: results of patients’ and surgeons’ survey

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alicja Dudek ◽  
Michał Wysocki ◽  
Maciej Walędziak ◽  
Jacek Szeliga ◽  
Monika Proczko-Stepaniak ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Body Mass Index ◽  
World Health ◽  
Online Surveys ◽  
The World ◽  
Bariatric Patients ◽  
Group 2 ◽  
Health Organization ◽  
Current Body Mass Index ◽  
Group 1

Abstract Background Coronavirus Disease 2019 is affecting most countries around the world, including Poland. In response, all elective surgeries have been postponed. We asked patients and surgeons when they want bariatric surgery to resume after pandemic. The main aim of the study was to determine patients’ and surgeons’ expectations about when to resume bariatric surgery regarding COVID-19 pandemic state. Methods The study was conducted in two groups: Group 1—bariatric patients; Group 2—bariatric surgeons. Two online surveys were distributed. Results A total of 895 patients, 299 before, 596 after surgery and 32 surgeons took part in survey. All patients and surgeons declared willingness to resume bariatric surgeries after pandemic and responded that they should be resumed immediately the World Health Organization announces end of pandemic (42%). The majority of patients before surgery answered that bariatric procedures should be resumed immediately the number of daily incidents begins to decrease (53%). In the patient group, current body mass index (p < 0.001) and contact with COVID+/quarantined persons (p < 0.001) had impact on the response to resumption of bariatric procedures. Conclusions Patients opted to wait for bariatric surgery until the oncological queue has become shorter. Surgeons presented a readiness to resume both procedures in parallel.

scholarly journals Endocrine markers of semistarvation in healthy lean men in a multistressor environment

2000 ◽  
Vol 88 (5) ◽  
pp. 1820-1830 ◽  
Author(s):  
Karl E. Friedl ◽  
Robert J. Moore ◽  
Reed W. Hoyt ◽  
Louis J. Marchitelli ◽  
Lester E. Martinez-Lopez ◽  
...  
Keyword(s):  
Body Fat ◽  
Specific Binding ◽  
Thermal Strain ◽  
Young Male ◽  
Gonadal Hormone ◽  
Us Army ◽  
Igf I ◽  
Elevated Cholesterol ◽  
Group 2 ◽  
Group 1

We tested the hypothesis that key endocrine responses to semistarvation would be attenuated by changing only the food intake in a multistressor environment that also included sustained workload, inadequate sleep, and thermal strain. Serum hormones were compared within and between two groups of healthy young male volunteers participating in the 8-wk US Army Ranger course, with four repeated cycles of restricted energy intakes and refeeding: group 1 ( n = 49) and group 2 ( n = 48); energy deficits averaged 1,200 and 1,000 kcal/day, respectively. After 8 wk, most of group 1 achieved a minimum body fat, serum 3,5,3′-triiodothyronine (T3) was below normal (78 ± 20 ng/dl), testosterone (T) approached castrate levels (4.5 ± 3.9 nmol/l), insulin-like growth factor I (IGF-I) declined by one-half (75 ± 25 μg/l), and cholesterol rose from 158 ± 31 to 217 ± 39 mg/dl. Bioavailable T3 and T were further reduced by increases in their specific binding proteins in response to declining insulin. Refeeding, even with continuation of the other stressors, produced prompt recovery of T3, T, and IGF-I. Higher energy intakes in group 2 attenuated the subclinical hypothyroidism and hypercholesterolemia, whereas consistent luteinizing hormone suppression indicated centrally mediated threshold effects on gonadal hormone suppression. We conclude that low T, T3, and IGF-I remained reliable markers of acute energy deficits in the presence of other stressors; elevated cholesterol and cortisol provided information about chronic status, corresponding to diminishing body fat stores.

Effects of insulin-like growth factor–I and platelet-rich plasma on sciatic nerve crush injury in a rat model

2011 ◽  
Vol 114 (2) ◽  
pp. 522-528 ◽  
Author(s):  
Erhan Emel ◽  
Selma Sönmez Ergün ◽  
Dilcan Kotan ◽  
Esra Başar Gürsoy ◽  
Yeşim Parman ◽  
...  
Keyword(s):  
Functional Recovery ◽  
Rat Model ◽  
Platelet Rich Plasma ◽  
Sensory Function ◽  
Local Administration ◽  
Control Group ◽  
Factor I ◽  
Igf I ◽  
Group 2 ◽  
Group 1

Object Local administration of insulin-like growth factor–I (IGF-I) has been shown to increase the rate of axon regeneration in crush-injured and freeze-injured rat sciatic nerves. Local administration of platelet-rich plasma (PRP) has been also shown to have a measurable effect on facial nerve regeneration after transection in a rat model. The objective of the study was to compare the effects of locally administered IGF-I and PRP on the parameters of the Sciatic Function Index (SFI), sensory function (SF), axon count, and myelin thickness/axon diameter ratio (G-ratio) in a rat model of crush-injured sciatic nerves. Methods The right sciatic nerve of Wistar albino rats (24 animals) was crushed using a Yasargil-Phynox aneurysm clip for 45 minutes. All animals were randomly divided into 3 groups: Group 1 (control group) was treated with saline, Group 2 was treated with IGF-I, and Group 3 was treated with PRP. Injections were performed using the tissue expander's injection port with a connecting tube directed at the crush-injured site. Functional recovery was assessed with improvement in the SFI. Recovery of sensory function was using the pinch test. Histopathological examination was performed 3 months after the injury. Results The SFI showed an improved functional recovery in the IGF-I–treated animals (Group 2) compared with the saline-treated animals (Group 1) 30 days after the injury. In IGF-I–treated rats, sensory function returned to the baseline level significantly faster than in saline-treated and PRP-treated rats as shown in values between SF-2 and SF-7. The G-ratios were found to be significantly higher in both experimental groups than in the control group. Conclusions This study suggests that the application of IGF-I to the crush-injured site may expedite the functional recovery of paralyzed muscle by increasing the rate of axon regeneration.

scholarly journals Can Body Mass Index Affect Height Growth at Menarche among Girls Receiving Treatment for Early Puberty? A Retrospective Study in Korean Girls

Children ◽  
2022 ◽  
Vol 9 (1) ◽  
pp. 110
Author(s):  
Sun-Jin Lee ◽  
Sun-Young Kim ◽  
Minsun Kim
Keyword(s):  
Body Mass Index ◽  
Body Weight ◽  
Body Mass ◽  
Central Precocious Puberty ◽  
Early Puberty ◽  
Time Points ◽  
Height Gain ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Gonadotropin-releasing hormone agonist (GnRHa) therapy is used to control puberty progression and it preserves height potential in patients with idiopathic central precocious puberty (ICPP). This study evaluated the correlation between weight and height gain at menarche following GnRHa treatment among girls with ICPP and relatively central early puberty (EP). We investigated height/weight trends and changes in height from diagnosis to menarche in girls with ICPP and EP treated with GnRHa. The mean difference in height (Δheight) from treatment cessation to menarche was 9.79 ± 3.53 cm. Girls were divided into girls with Δheight ≥ 9.79 cm (Group 1) and girls with Δheight < 9.79 cm (Group 2). Although near adult height was significantly higher in Group 1, the mean body mass index (BMI) and weight were significantly lower at diagnosis, treatment discontinuation, and menarche. The BMI and weight at the three time points were negatively correlated with height. Girls with higher BMI at all three time points had slower growth rates during the study period. Considering that BMI and body weight were closely related to Δheight, proper management of BMI and body weight of girls receiving early puberty treatment might contribute to growth during and after GnRHa treatment.

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