ENDOCRINE DISTURBANCES IN PATIENTS WITH CONGENITAL AQUEDUCTAL STENOSIS

1975 ◽  
Vol 80 (1) ◽  
pp. 1-13 ◽  
Author(s):  
Robert Fiedler ◽  
Dorothy T. Krieger
Keyword(s):  
Present Report ◽  
Aqueductal Stenosis ◽  
Tolerance Test ◽  
Insulin Tolerance Test ◽  
Endocrine Function ◽  
Insulin Tolerance ◽  
Endocrine Disturbances ◽  
Reversible Lesion ◽  
Hormone Responses

ABSTRACT Congenital stenosis of the aqueduct of Sylvius is reported to be associated with sella turcia enlargement and clinical and laboratory abnormalities of the hypothalamic-pituitary-target-organ axis. It is a surgically reversible lesion. In the present report, 3 female patients with this lesion were studied with tests of basal endocrine function, as well as insulin tolerance tests, response to metyrapone and determination of circadian periodicity of plasma cortisol levels. In one patient all testing was normal and no surgery was performed. In 2 other patients the insulin tolerance test revealed either abnormal cortisol or growth hormone responses and in one patient urinary gonadotrophins were absent. All tests became normal post-operatively although in one instance not completely so until 5 years after surgery.

scholarly journals Determination of Free Growth Hormone

2008 ◽  
Vol 93 (8) ◽  
pp. 3008-3014 ◽  
Author(s):  
Jan Frystyk ◽  
Caroline Marie Andreasen ◽  
Sanne Fisker
Keyword(s):  
Growth Hormone ◽  
Area Under The Curve ◽  
Tolerance Test ◽  
Insulin Tolerance Test ◽  
Clinical Use ◽  
Serum Free ◽  
High Affinity ◽  
Insulin Tolerance ◽  
Free Growth

Abstract Context: Approximately 50% of circulating GH is bound to the high-affinity GH-binding protein (GHBP), which is known to affect the pharmacokinetics, bioactivity, and quantitative determination of GH. Nevertheless, the presence of GHBP is rarely taken into account in the clinical use of GH measurements. Objective: Our objective was to develop an assay for free GH in serum. Methods: We used ultrafiltration by centrifugation. Due to the small molecular difference between GH and GHBP, the size of GHBP and GHBP-GH complexes was increased by preincubation of serum with a monoclonal GHBP antibody (MAb 263). Results: The ultrafiltration membrane almost completely retained all GHBP (>98.5%) and allowed free passage of unbound GH (>98.4%). Addition of increasing concentrations of GHBP reduced free GH dose dependently, and measured and calculated levels of free GH changed in parallel. During an insulin-tolerance test, free and total GH changed in parallel in all individuals (n = 11) and their peak values as well as area under the curve values were positively correlated (r = 0.89; P < 0.001 and r = 0.92; P < 0.001, respectively). Of note, the relative levels of free GH (calculated as the area under the curve of free to total GH) was inversely correlated with GHBP (r = −0.94; P < 0.001). Conclusion: It is possible to measure free GH in human serum. Free GH correlated positively with total GH and inversely with GHBP. Measurement of free GH may be a helpful future tool in the management of GH disorders and in studies of GH-GHBP interrelationships.

Influence of insulin-induced hypoglycemia on the hemostatic and fibrinolytic system in patients with hypothalamicpituitary disorders

1998 ◽  
Vol 18 (02) ◽  
pp. 74-79
Author(s):  
K.-H. Zurborn ◽  
H. D. Bruhn ◽  
H. Mönig
Keyword(s):  
Factor Viii ◽  
Plasminogen Activator ◽  
Tolerance Test ◽  
Insulin Tolerance Test ◽  
Fibrinolytic System ◽  
Tissue Type ◽  
Insulin Tolerance ◽  
Factor Viii Antigen ◽  
Pai 1 ◽  
D Dimer

SummaryIn order to study the acute and prolonged effects of hypoglycemia on the hemostatic and fibrinolytic system we measured prothrombin fragment (F1+2), thrombin-antithrombin III complex (TAT), platelet factor 4 (PF4), β-thromboglobulin (âTG), factor VIII antigen (F VIII antigen), D-dimer, tissue-type plasminogen activator (t-PA) antigen, and plasminogen activator inhibitor (PAI-1) in 22 patients during insulin tolerance test. F1+2 and TAT increased significantly 15 and 90 minutes after administration of insulin, as did PF4 and âTG. At 4 and 24 hours, these parameters were not different from baseline. Factor VIII antigen was not significantly altered. D-dimer concentration did not change. However, the D-dimer/TAT ratio significantly decreased at 15 and 90 minutes but increased markedly above baseline at 4 and 24 hours. t-PA antigen was also found to be elevated at 15 and 90 minutes but had returned to baseline at 4 and 24 hours. PAI-1 concentration did not change. We conclude from these data that both coagulation and fibrinolysis are activated in the short-term response to acute insulin-induced hypoglycemia, followed by a prolonged activation of fibrinolysis. Our study may explain why patients undergoing insulin tolerance test, despite marked clotting and platelet activation, almost never develop thromboembolic complications.

Reproducibility of the Short Insulin Tolerance Test

1993 ◽  
Vol 10 (9) ◽  
pp. 839-842 ◽  
Author(s):  
S. Hirst ◽  
D.I.W. Phillips ◽  
S.K. Vines ◽  
P.M. Clark ◽  
C.N. Hales
Keyword(s):  
Tolerance Test ◽  
Insulin Tolerance Test ◽  
Insulin Tolerance

The insulin tolerance test (ITT) in the assessment of the adrenal axis

2021 ◽  
Author(s):  
Sahar Abidi ◽  
Wafa Grira ◽  
Nadia Khessairi ◽  
Ibtissem Oueslati ◽  
Meriem Yazidi ◽  
...  
Keyword(s):  
Tolerance Test ◽  
Insulin Tolerance Test ◽  
Adrenal Axis ◽  
Insulin Tolerance

scholarly journals Influence of Body Mass Index and Gender on Growth Hormone (GH) Responses to GH-Releasing Hormone Plus Arginine and Insulin Tolerance Tests

2005 ◽  
Vol 90 (3) ◽  
pp. 1563-1569 ◽  
Author(s):  
Xiao-Dan Qu ◽  
Irene T. Gaw Gonzalo ◽  
Mohammed Y. Al Sayed ◽  
Pejman Cohan ◽  
Peter D. Christenson ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Gender Differences ◽  
Body Mass ◽  
Healthy Subjects ◽  
Gh Deficiency ◽  
Tolerance Test ◽  
Insulin Tolerance Test ◽  
Insulin Tolerance ◽  
Stimulation Tests ◽  
And Gender

The aim of this study is to assess whether gender and body mass index (BMI) should be considered in developing thresholds to define GH deficiency, using GH responses to GHRH + arginine (ARG) stimulation and insulin tolerance test (ITT). Thirty-nine healthy subjects (19 males, 20 females; ages 21–50 yr) underwent GHRH + ARG, and another 27 subjects (19 males, 8 females; ages 20–49 yr) underwent ITT. Peak GH response was significantly higher (P = 0.005) after GHRH + ARG than with ITT, and this difference could not be explained by age, gender, or BMI. Peak GH response was negatively correlated with BMI in both tests (GHRH + ARG, r = −0.76; and ITT, r = −0.65). Peak GH response to GHRH + ARG was higher in females than males (P = 0.004; ratio = 2.4), but it was attenuated after eliminating the influence of BMI (P = 0.13; ratio = 1.6). No significant gender differences were found in peak GH responses to ITT, which could be due to the smaller number of female subjects studied. GH response to GHRH + ARG and ITT stimulation is sensitive to BMI differences and less so to gender differences. A higher BMI is associated with a depressed GH response to both stimulation tests. BMI should therefore be considered as a factor when defining the diagnostic cut-off points in the assessment of GH deficiency, whereas whether gender should be likewise used is inconclusive from this study.

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