LOW CIRCULATING IGF-I LEVELS IN HYPERTHYROIDISM ARE ASSOCIATED WITH DECREASED GH RESPONSE TO GH-RELEASING HORMONE

OBJECTIVE Several abnormalities in the GH response to pharmacological stimuli have been described in hyperthyroidism. Both normal and high serum IGF-l levels have been reported, as well as a decrease in IGF-I bioactivity. We have evaluated the GH response to OH-releasing hormone (GHRH) in hyperthyroid patients and the effects of hyperthyroidism on serum IGF-l levels. The possible relations between nutritional status, thyroid hormones and IGF-I levels were also investigated. We also studied the influence of long-term beta-adrenoceptor blockade on the OH response to GHRH in these patients. DESIGN In 18 hyperthyroid patients and in 12 control subjects, GHRH (100 mu g) was administered as an i.v. bolus injection. Eight hyperthyroid patients and 8 control subjects received 50 mu g GHRH i.v. Seven hyperthyroid patients were reevaluated after P-adrenoceptor blockade. IGF-l and albumin levels were measured initially in all hyperthyroid patients and control subjects. Body composition was determined in 11 hyperthyroid patients and in a group of 33 matched normal controls. PATIENTS Hyperthyroid patients were compared to control subjects. MEASUREMENTS GH, TSH and free T4 were measured by immunofluorometric assay. IGF-l, total T3 and total T4 were measured by radioimmunoassay. Body composition was determined using a dual-energy X-ray absorptiometer. RESULTS The GH response to 100 mu g GHRH in hyperthyroid patients was blunted compared to control subjects. The mean peak OH levels and the area under the curve were significantly lower in hyperthyroid patients compared to control subjects (11 +/- 1 vs 27 +/- 5 mu g/l and 820 +/- 113 vs 1879 +/- 355 mu g/l 120min, respectively; P < 0.01). IGF-I levels were significantly reduced in hyperthyroid patients compared to controls (131 +/- 10 vs 201 +/- 16 mu g/l, respectively; P < 0.01). Ideal body weight, serum albumin levels and the lean body mass were also reduced in hyperthyroid patients. After beta-adrenoceptor blockade there were no changes in the blunted GH response to GHRH in hyperthyroid patients. CONCLUSION Our data suggest that the blunted on response to GHRH in hyperthyroidism is apparently not related to circulating IGF-I levels. It is possible that nutritional factors could play a role in the reduced circulating IGF-l levels found in these patients.