URINARY GROWTH-HORMONE IN DIABETIC KETOACIDOSIS

Growth hormone (GH) was measured by radioimmunoassay in the urine of diabetics admitted to hospital with ketoacidosis. On the first day of treatment the median immunoreactive growth hormone (IRGH) excretion rate was 3800 ng/hr (range 520-40,000 ng/.hr, n = 6), on the second day, 2450 ng/hr (300-9700 ng/hr, n = 6), on the third day, 100 ng/hr (4-6700 ng/hr, n = 5), and on the fourth day, 80 ng/hr (5-4900 ng/hr, n = 5). Three to eight months after treatment for ketosis, the GH excretion rates of 3 of the patients were 0.6, 1.8 and 1.9 ng/hr. In nine normals the excretion rate ranged from undetectable to 1 ng/hr. The high concentration of urinary IRGH in the ketotic patients made possible comparison of its immunological and physical properties with those of extracted pituitary GH (epGH). Immunological similarity was indicated by parallelism of dilutions of urinary IRGH and epGH and similar potency estimates using two different antisera. No significant difference in molecular weight or electrical charge could be detected by polyacrylamide gel electrophoresis at pH 4 or 9, and by gel filtration. It is concluded that in ketoacidosis greatly elevated quantities of a GH-like material are excreted in the urine and it is suggested that this may be due to tubular dysfunction. This GH-like material is similar or identical to pituitary GH and hence it may be concluded that at least a portion of plasma GH is also similar to pituitary and urinary GH.