The effect of short-term cortisol changes on growth hormone responses to the pyridostigmine-growth-hormone-releasing-hormone test in healthy adults and patients with suspected growth hormone deficiency

M Andersen, R K Støving, J Hangaard, P H Petersen, C Hagen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Udgivelsesdato: 1998-Aug
OriginalsprogEngelsk
TidsskriftClinical Endocrinology
Vol/bind49
Udgave nummer2
Sider (fra-til)241-9
Antal sider8
ISSN0300-0664
StatusUdgivet - 1998

Fingeraftryk

Pyridostigmine Bromide
Glucocorticoids

Citer dette

@article{233f5790439711deb5e8000ea68e967b,
title = "The effect of short-term cortisol changes on growth hormone responses to the pyridostigmine-growth-hormone-releasing-hormone test in healthy adults and patients with suspected growth hormone deficiency",
abstract = "BACKGROUND AND AIMS: The interaction between cortisol and growth hormone (GH)-levels may significantly influence GH-responses to a stimulation test. In order to systematically analyse the interaction in a paired design, it is necessary to use a test, which has been proven safe and reliable such as the pyridostigmine-growth-hormone-releasing-hormone (PD-GHRH) test. Three groups of subjects with a different GH-secretory capacity were included. STUDY A: Eight healthy adults were tested seven times, once with placebo throughout the examination and six times with the PD-GHRH test following no glucocorticoid pretreatment, pretreatment with hydrocortisone (HC) (30 mg/day and 80 mg/day for 1 and 3 days) or pretreatment with 15 mg prednisolone for 1 day. HC (80 mg/day for 1 day) in combination with PD significantly stimulated GH-levels compared to PD alone, 18.9 mU/l +/- 6.1 vs 3.0 mU/l +/- 0.8 (P < 0.05). However, peak GH-responses to PD in combination with GHRH were reduced during HC (80 mg/day for 1 day) compared to no glucocorticoid pretreatment in all healthy adults. Conventional HC therapy (30 mg/day for 1 and 3 days) did not significantly affect peak GH-responses. STUDY B: 16 patients with suspected GH-deficiency (GHD) (seven with known ACTH-deficiency and nine with an intact pituitary-adrenal axis) were tested five times with the PD-GHRH test following no pretreatment or pretreatment with HC (30 mg/day and 80 mg/day for 1 and 3 days). Peak GH-responses were not significantly affected by conventional HC therapy (30 mg/day for 1 and 3 days). However, peak GH-responses to PD in combination with GHRH were reduced during HC (80 mg/day for 1 day) compared to no glucocorticoid pretreatment in all patients. Short-term hypocortisolism did not significantly affect peak GH-responses. CONCLUSION: The GH-responses to a PD-GHRH test were reduced in all individuals during acute stress-appropriate cortisol levels and the percentage reduction in GH-levels was independent of the GH-secretory capacity. Clinically, we found that peak GH-responses were not significantly affected by a short break in conventional HC therapy nor by conventional HC therapy itself. However, our results also demonstrated that a GH-stimulation test should not be performed on patients, suffering from acute stress.",
keywords = "Adrenocorticotropic Hormone, Adult, Cholinesterase Inhibitors, Drug Therapy, Combination, Female, Glucocorticoids, Growth Hormone, Growth Hormone-Releasing Hormone, Humans, Hydrocortisone, Male, Middle Aged, Pituitary Function Tests, Predictive Value of Tests, Prednisolone, Pyridostigmine Bromide, Stimulation, Chemical, Stress, Psychological",
author = "M Andersen and St{\o}ving, {R K} and J Hangaard and Petersen, {P H} and C Hagen",
year = "1998",
language = "English",
volume = "49",
pages = "241--9",
journal = "Clinical Endocrinology",
issn = "0300-0664",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - The effect of short-term cortisol changes on growth hormone responses to the pyridostigmine-growth-hormone-releasing-hormone test in healthy adults and patients with suspected growth hormone deficiency

AU - Andersen, M

AU - Støving, R K

AU - Hangaard, J

AU - Petersen, P H

AU - Hagen, C

PY - 1998

Y1 - 1998

N2 - BACKGROUND AND AIMS: The interaction between cortisol and growth hormone (GH)-levels may significantly influence GH-responses to a stimulation test. In order to systematically analyse the interaction in a paired design, it is necessary to use a test, which has been proven safe and reliable such as the pyridostigmine-growth-hormone-releasing-hormone (PD-GHRH) test. Three groups of subjects with a different GH-secretory capacity were included. STUDY A: Eight healthy adults were tested seven times, once with placebo throughout the examination and six times with the PD-GHRH test following no glucocorticoid pretreatment, pretreatment with hydrocortisone (HC) (30 mg/day and 80 mg/day for 1 and 3 days) or pretreatment with 15 mg prednisolone for 1 day. HC (80 mg/day for 1 day) in combination with PD significantly stimulated GH-levels compared to PD alone, 18.9 mU/l +/- 6.1 vs 3.0 mU/l +/- 0.8 (P < 0.05). However, peak GH-responses to PD in combination with GHRH were reduced during HC (80 mg/day for 1 day) compared to no glucocorticoid pretreatment in all healthy adults. Conventional HC therapy (30 mg/day for 1 and 3 days) did not significantly affect peak GH-responses. STUDY B: 16 patients with suspected GH-deficiency (GHD) (seven with known ACTH-deficiency and nine with an intact pituitary-adrenal axis) were tested five times with the PD-GHRH test following no pretreatment or pretreatment with HC (30 mg/day and 80 mg/day for 1 and 3 days). Peak GH-responses were not significantly affected by conventional HC therapy (30 mg/day for 1 and 3 days). However, peak GH-responses to PD in combination with GHRH were reduced during HC (80 mg/day for 1 day) compared to no glucocorticoid pretreatment in all patients. Short-term hypocortisolism did not significantly affect peak GH-responses. CONCLUSION: The GH-responses to a PD-GHRH test were reduced in all individuals during acute stress-appropriate cortisol levels and the percentage reduction in GH-levels was independent of the GH-secretory capacity. Clinically, we found that peak GH-responses were not significantly affected by a short break in conventional HC therapy nor by conventional HC therapy itself. However, our results also demonstrated that a GH-stimulation test should not be performed on patients, suffering from acute stress.

AB - BACKGROUND AND AIMS: The interaction between cortisol and growth hormone (GH)-levels may significantly influence GH-responses to a stimulation test. In order to systematically analyse the interaction in a paired design, it is necessary to use a test, which has been proven safe and reliable such as the pyridostigmine-growth-hormone-releasing-hormone (PD-GHRH) test. Three groups of subjects with a different GH-secretory capacity were included. STUDY A: Eight healthy adults were tested seven times, once with placebo throughout the examination and six times with the PD-GHRH test following no glucocorticoid pretreatment, pretreatment with hydrocortisone (HC) (30 mg/day and 80 mg/day for 1 and 3 days) or pretreatment with 15 mg prednisolone for 1 day. HC (80 mg/day for 1 day) in combination with PD significantly stimulated GH-levels compared to PD alone, 18.9 mU/l +/- 6.1 vs 3.0 mU/l +/- 0.8 (P < 0.05). However, peak GH-responses to PD in combination with GHRH were reduced during HC (80 mg/day for 1 day) compared to no glucocorticoid pretreatment in all healthy adults. Conventional HC therapy (30 mg/day for 1 and 3 days) did not significantly affect peak GH-responses. STUDY B: 16 patients with suspected GH-deficiency (GHD) (seven with known ACTH-deficiency and nine with an intact pituitary-adrenal axis) were tested five times with the PD-GHRH test following no pretreatment or pretreatment with HC (30 mg/day and 80 mg/day for 1 and 3 days). Peak GH-responses were not significantly affected by conventional HC therapy (30 mg/day for 1 and 3 days). However, peak GH-responses to PD in combination with GHRH were reduced during HC (80 mg/day for 1 day) compared to no glucocorticoid pretreatment in all patients. Short-term hypocortisolism did not significantly affect peak GH-responses. CONCLUSION: The GH-responses to a PD-GHRH test were reduced in all individuals during acute stress-appropriate cortisol levels and the percentage reduction in GH-levels was independent of the GH-secretory capacity. Clinically, we found that peak GH-responses were not significantly affected by a short break in conventional HC therapy nor by conventional HC therapy itself. However, our results also demonstrated that a GH-stimulation test should not be performed on patients, suffering from acute stress.

KW - Adrenocorticotropic Hormone

KW - Adult

KW - Cholinesterase Inhibitors

KW - Drug Therapy, Combination

KW - Female

KW - Glucocorticoids

KW - Growth Hormone

KW - Growth Hormone-Releasing Hormone

KW - Humans

KW - Hydrocortisone

KW - Male

KW - Middle Aged

KW - Pituitary Function Tests

KW - Predictive Value of Tests

KW - Prednisolone

KW - Pyridostigmine Bromide

KW - Stimulation, Chemical

KW - Stress, Psychological

M3 - Journal article

C2 - 9828914

VL - 49

SP - 241

EP - 249

JO - Clinical Endocrinology

JF - Clinical Endocrinology

SN - 0300-0664

IS - 2

ER -