Human growth hormone (GH) isoforms during oral glucose tolerance test in patients with acromegaly and in healthy subjects

2018 ◽  
Author(s):  
Esther Ulmer ◽  
Katharina Schilbach ◽  
Michael Haenelt ◽  
Shiva Sophia Nicolay ◽  
Laura Schwerdt ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Healthy Subjects ◽  
Glucose Tolerance Test ◽  
Human Growth ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Gh Isoforms

scholarly journals Determinants of the growth hormone nadir during oral glucose tolerance test in adults

2019 ◽  
Vol 181 (1) ◽  
pp. 55-67 ◽  
Author(s):  
Katharina Schilbach ◽  
Christina Gar ◽  
Andreas Lechner ◽  
Shiva Sophia Nicolay ◽  
Laura Schwerdt ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Healthy Subjects ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Healthy Adults ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Biological Variables

Objective Growth hormone (GH) nadir (GHnadir) during oral glucose tolerance test (OGTT) is an important tool in diagnosing acromegaly, but data evaluating the need to adjust cut-offs to biological variables utilizing today's assay methods are scarce. We therefore investigated large cohorts of healthy subjects of both sexes to define normal GHnadir concentrations for a modern, sensitive, 22 kD-GH-specific assay. Design Multicenter study with prospective and retrospective cohorts (525 healthy adults: 405 females and 120 males). Methods GH concentrations were measured by the IDS-iSYS immunoassay after oral application of 75 g glucose. Results GHnadir concentrations (µg/L) were significantly higher in lean and normal weight subjects (group A) compared to overweight and obese subjects (group B); (males (M): A vs B, mean: 0.124 vs 0.065, P = 0.0317; premenopausal females without estradiol-containing OC (OC-EE) (FPRE): A vs B, mean: 0.179 vs 0.092, P < 0.0001; postmenopausal women (FPOST): A vs B, mean: 0.173 vs 0.078, P < 0.0061). Age, glucose metabolism and menstrual cycle had no impact on GHnadir. However, premenopausal females on OC-EE (FPREOC) exhibited significantly higher GHnadir compared to all other groups (all P < 0.0001). BMI had no impact on GHnadir in FPREOC (A vs B, mean: 0.624 vs 0.274, P = 0.1228). Conclusions BMI, sex and OC-EE intake are the major determinants for the GHnadir during OGTT in healthy adults. Using a modern sensitive GH assay, GHnadir concentrations in healthy subjects are distinctly lower than cut-offs used in previous guidelines for diagnosis and monitoring of acromegaly.

GLUCOSE TOLERANCE, INSULIN AND GROWTH HORMONE IN INFANTS OF GESTATIONAL DIABETIC MOTHERS

PEDIATRICS ◽  
1970 ◽  
Vol 45 (3) ◽  
pp. 394-403
Author(s):  
Harold S. Cole ◽  
Joan H. Bilder ◽  
Rafael A. Camerini-Davalos ◽  
Richard D. Grimaldi
Keyword(s):  
Growth Hormone ◽  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Normal Control ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
The Mean ◽  
Diabetic Mothers

Twelve control and nine gestational diabetic mothers (GDM) and their infants were studied at birth. All GDM were obese. The criteria for selection of control mothers were a negative family history for diabetes, a normal oral glucose tolerance test, and the presence of obesity. The mean birth weights of the infants were not significantly different. All infants received a 3-hour oral glucose tolerance test (OGTT), completed within the first 24 hours of life. Glucose, serum immunoreactive insulin and growth hormone levels were determined. The mean glucose values obtained at the time of delivery revealed no significant differences between the GDM and the control mothers or between the infants of gestational diabetic mothers (IGDM) and the normal control infants. At birth, the mean seruni insulin levels of the GDM and the IGDM were both significantly higher than were their control GDM and IGDM. The OGTT was performed between 0 and 21 hours after birth and after a 4-hour fast. The mean fasting blood glucose level of the IGDM was significantly lower than that of the control infants, p≤.02. However, during the OGTT, the normal control infants showed a disposal of glucose similar to the IGDM. No evidence of hyperinsulinemia was observed in either the control infants or the infants of gestational diabetic mothers. The mean growth hormone values for the infants at the time of delivery revealed no significant differences between the two study groups. During the OGTT, the IGDM had significantly higher mean growth hormone values at both 60 and 120 minutes.

scholarly journals GH Response to Oral Glucose Tolerance Test: A Comparison between Patients with Acromegaly and Other Pituitary Disorders

Endocrinology ◽  
2010 ◽  
Vol 151 (12) ◽  
pp. 5973-5973
Author(s):  
E. Verrua ◽  
M. Filopanti ◽  
C. L. Ronchi ◽  
L. Olgiati ◽  
E. Ferrante ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Healthy Subjects ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Gh Secretion ◽  
Hypothalamic Function ◽  
The Impact

Context: The cutoff value of nadir GH after an oral glucose tolerance test (OGTT) used to define disease remission in acromegaly is higher than that observed in healthy subjects. However, it is uncertain whether the impaired GH inhibition might be related to subtle abnormalities of GH secretion or to functional and/or anatomical hypothalamic-pituitary disconnection due to tumor per se or treatments. Objective: The objective of the study was to evaluate the impact of pituitary disorders other than acromegaly on GH response to OGTT. Design, Subjects, and Methods: Thirty-three patients (24 females and nine males, aged 50.1 ± 12.3 yr, 13 operated and two irradiated) with various hypothalamic-pituitary disorders (HPDs), 45 healthy subjects (controls), and 42 cured acromegalic patients matched for sex, age. and body mass index were investigated. All subjects were studied for IGF-I levels and GH levels before and during the OGTT. Results: In HPD patients mean postglucose nadir GH levels were 0.11 ± 0.08 μg/liter without any difference between patients treated with neurosurgery and/or radiotherapy and untreated and between patients with and without pituitary stalk alterations and/or hyperprolactinemia. Mean nadir GH values were similar in HPD patients and controls (0.11 ± 0.08 vs. 0.08 ± 0.08 μg/liter, P = 0.23) and lower than those found in cured acromegalic patients (0.18 ± 0.13 μg/liter, P = 0.02), although there was an overlapping in about half of patients. Conclusions: Hypothalamic control of glucose-mediated GH suppression is not perturbed in patients with HPD. These data indicate that defective GH suppression to glucose that is found in acromegaly is unlikely to reflect a lack of integrity of hypothalamic function.

scholarly journals GH Response to Oral Glucose Tolerance Test: A Comparison between Patients with Acromegaly and Other Pituitary Disorders

2010 ◽  
Vol 31 (6) ◽  
pp. 945-945
Author(s):  
E. Verrua ◽  
M. Filopanti ◽  
C. L. Ronchi ◽  
L. Olgiati ◽  
E. Ferrante ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Healthy Subjects ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Gh Secretion ◽  
Hypothalamic Function ◽  
The Impact

Context The cutoff value of nadir GH after an oral glucose tolerance test (OGTT) used to define disease remission in acromegaly is higher than that observed in healthy subjects. However, it is uncertain whether the impaired GH inhibition might be related to subtle abnormalities of GH secretion or to functional and/or anatomical hypothalamic-pituitary disconnection due to tumor per se or treatments. Objective The objective of the study was to evaluate the impact of pituitary disorders other than acromegaly on GH response to OGTT. Design, Subjects, and Methods Thirty-three patients (24 females and nine males, aged 50.1 ± 12.3 yr, 13 operated and two irradiated) with various hypothalamic-pituitary disorders (HPDs), 45 healthy subjects (controls), and 42 cured acromegalic patients matched for sex, age. and body mass index were investigated. All subjects were studied for IGF-I levels and GH levels before and during the OGTT. Results In HPD patients mean postglucose nadir GH levels were 0.11 ± 0.08 μg/liter without any difference between patients treated with neurosurgery and/or radiotherapy and untreated and between patients with and without pituitary stalk alterations and/or hyperprolactinemia. Mean nadir GH values were similar in HPD patients and controls (0.11 ± 0.08 vs. 0.08 ± 0.08 μg/liter, P = 0.23) and lower than those found in cured acromegalic patients (0.18 ± 0.13 μg/liter, P = 0.02), although there was an overlapping in about half of patients. Conclusions Hypothalamic control of glucose-mediated GH suppression is not perturbed in patients with HPD. These data indicate that defective GH suppression to glucose that is found in acromegaly is unlikely to reflect a lack of integrity of hypothalamic function.

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