Body mass index determines evoked growth hormone (GH) responsiveness in normal healthy male subjects: Diagnostic caveat for adult GH deficiency

被引:90
作者
Bonert, VS [1 ]
Elashoff, JD [1 ]
Barnett, P [1 ]
Melmed, S [1 ]
机构
[1] Univ Calif Los Angeles, Dept Med, Cedars Sinai Med Ctr, David Geffen Sch Med, Los Angeles, CA 90048 USA
关键词
D O I
10.1210/jc.2003-032213
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
GH secretion is decreased in obese subjects, whereas age-adjusted IGF-I concentrations are normal. This study was undertaken to rigorously delineate the extent of obesity [elevated body mass index (BMI)] associated with decreased somatotrope secretory function resulting in apparent adult GH deficiency. The peak GH response evoked by combined arginine (0.5 g/kg infused iv over 30 min) and GHRH (1 mug/kg iv bolus) was measured in 59 healthy male subjects with BMIs ranging from normal to obese. BMI correlated with the peak evoked GH response (Pearson r=-0.59; P<0.01), and the percentage of subjects exhibiting an abnormal evoked GH response, i.e. less than 9 ng/ml, increased from 5% for those with a BMI less than 25 ( normal), to 13% for those with a BMI of 25-26.9 (mildly overweight), to 33% for those with a BMI of 27-29.9 (moderately overweight), and to 64% for those with a BMI of 30 or more (obese). BMI is a major determinant of evoked adult GH response to provocative testing. The diagnosis of adult GH deficiency using the evoked GH response in patients with even mild BMI elevation does not accurately distinguish normal from deficient responses and may result in the erroneous classification of obese subjects as GH deficient and thus unnecessarily requiring GH replacement.
引用
收藏
页码:3397 / 3401
页数:5
相关论文
共 42 条
[1]   Short procedure of GHRH plus arginine test in clinical practice [J].
Aimaretti G. ;
Bellone S. ;
Baffoni C. ;
Corneli G. ;
Origlia C. ;
Di Vito L. ;
Rovere S. ;
Arvat E. ;
Camanni F. ;
Ghigo E. .
Pituitary, 2001, 4 (3) :129-134
[2]   Comparison between insulin-induced hypoglycemia and growth hormone (GH)-releasing hormone plus arginine as provocative tests for the diagnosis of GH deficiency in adults [J].
Aimaretti, G ;
Corneli, G ;
Razzore, P ;
Bellone, S ;
Baffoni, C ;
Arvat, E ;
Camanni, F ;
Ghigo, E .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1998, 83 (05) :1615-1618
[3]  
Attanasio A, 1998, J CLIN ENDOCR METAB, V83, P379
[4]   Sensitivity and specificity of six tests for the diagnosis of adult GH deficiency [J].
Biller, BMK ;
Samuels, MH ;
Zagar, A ;
Cook, DM ;
Arafah, BM ;
Bonert, V ;
Stavrou, S ;
Kleinberg, DL ;
Chipman, JJ ;
Hartman, ML .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2002, 87 (05) :2067-2079
[5]   Abdominal visceral fat and fasting insulin are important predictors of 24-hour GH release independent of age, gender, and other physiological factors [J].
Clasey, JL ;
Weltman, A ;
Patrie, J ;
Weltman, JY ;
Pezzoli, S ;
Bouchard, C ;
Thorner, MO ;
Hartman, ML .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2001, 86 (08) :3845-3852
[6]   FACTORS CONTROLLING BLOOD-CONCENTRATION OF SOMATOMEDIN-C [J].
CLEMMONS, DR ;
VANWYK, JJ .
CLINICS IN ENDOCRINOLOGY AND METABOLISM, 1984, 13 (01) :113-143
[7]   THE RELATIONSHIP BETWEEN INSULIN-LIKE GROWTH FACTOR-I, ADIPOSITY, AND AGING [J].
COPELAND, KC ;
COLLETTI, RB ;
DEVLIN, JT ;
MCAULIFFE, TL .
METABOLISM-CLINICAL AND EXPERIMENTAL, 1990, 39 (06) :584-587
[8]   MASSIVE GROWTH-HORMONE (GH) DISCHARGE IN OBESE SUBJECTS AFTER THE COMBINED ADMINISTRATION OF GH-RELEASING HORMONE AND GHRP-6 - EVIDENCE FOR A MARKED SOMATOTROPH SECRETORY CAPABILITY IN OBESITY [J].
CORDIDO, F ;
PENALVA, A ;
DIEGUEZ, C ;
CASANUEVA, FF .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1993, 76 (04) :819-823
[9]  
FISCHER S, 1998, GROWTH HORM IGF I S, V8, pA31
[10]  
French SA, 1996, INT J OBESITY, V20, P303