Clinical Associations of 11-Hydroxycorticosteroid Suppression and Non-suppression in Severe Depressive Illnesses

Fifty patients with severe depression were separated into two groups by the responses of their plasma 11-hydroxycorticosteriod levels to a midnight dose of 2 mg. of dexamethasone. Clinical and questionary comparisons were made between the two groups of patients, who were similar as regards age, sex, and length of symptoms before admission to hospital. No differences were found between the groups of severely ill patients as regards the severity of their depression and anxiety assessed by questionary. Nevertheless, agitation was significantly greater in the patients whose corticosteroid levels were not suppressed by dexamethasone and adverse childhood experiences in those whose levels were suppressed.     

Plasma 11-Hydroxycorticoid Levels after Carbenoxolone Sodium

A definite rise in plasma 11-hydroxycorticoid levels has been shown in eight patients with duodenal ulcer following the oral administration of carbenoxolone sodium. A similar rise was seen in one patient with sarcoidosis whose pituitary A.C.T.H. secretion had been acutely suppressed with dexamethasone. No such rise, however, was seen in three patients suffering from adrenal insufficiency. It is suggested that carbenoxolone acts directly on the adrenal cortex, causing an increased production of corticosteroids.     

Plasma and Urinary Luteinizing Hormone Levels in the Diagnosis of Endocrine Disease

The diagnostic value of measurements of plasma and urinary luteinizing hormone (LH) has been studied in 209 patients with endocrine disease. In 44 patients puberty was either delayed or had failed to occur. In those with chromosomal abnormalities the LH levels were often within the normal range, whereas those with a pituitary cause usually had low levels. In boys with delayed puberty plasma LH levels rose before physical changes occurred and had prognostic value. In patients with later gonadal failure, men with impotence or infertility, and women with secondary amenorrhoea LH assays proved of little value, although in one case a premature menopause was suspected and six patients with anorexia nervosa had low LH levels.Sixty patients with disorders of the hypothalamicpituitary area were studied. Levels of LH were measured and considered in relation to the other anterior pituitary hormones. Impairment of LH secretion was one of the first effects on hormone production of disease affecting this area, and this was, of course, most readily detected in postmenopausal women.The normal ranges of both plasma and urine LH are wide and there seems to be considerable day-to-day variation, especially of urinary output. Several samples should, therefore, be measured if therapeutic decisions are involved.     

Plasma Levels of Growth Hormone,Insulin, Sugar and Acetoacetate in Cattle. Diurnal Variations and Responses to Feeding

The fundamental differences between monogastric animals and ruminants as regards the handling of dietary carbohydrates and as regards the relative importance of gluconeogenesis, rise interesting questions as to the factors regulating the secretion of growth hormone and insulin in poly gastric animals.     

Alterations In Thyroid Hormone Levels Following Growth Hormone Replacement Exert Complex Biological Effects

Objective: Alterations in the thyroid axis are frequently observed following growth hormone (GH) replacement, but uncertainty exists regarding their clinical significance. We aimed to compare fluctuations in circulating thyroid hormone levels, induced by GH, to changes in sensitive biological markers of thyroid hormone action.Methods: This was a prospective observational clinical study. Twenty hypopituitary men were studied before and after GH replacement. Serum thyroid-stimulating hormone (TSH), thyroid hormones, and insulin-like growth factor 1 were measured. Changes in thyroid hormone concentrations were compared to alterations in resting metabolic rate and cardiac time intervals. Health-related quality of life (QOL) was assessed by disease-sensitive and generic questionnaires.Results: Following GH replacement, free thyroxine concentration declined and free triiodothyronine level increased. Resting energy expenditure increased, particularly in subjects with profound hypopituitarism, including TSH deficiency (16.73 ± 1.75 kcal/kg/min vs. 17.96 ± 2.26 kcal/kg/min; P = .01). Alterations in the thyroid axis were more pronounced in subjects with a low/normal baseline respiratory quotient (RQ) who experienced a paradoxical rise in RQ (0.81 vs. 0.86; P = .01). Subjects with a high baseline RQ experienced a slight but nonsignificant fall in RQ without alteration in thyroid axis. The isovolumetric contraction time was shortened during the study; however, this did not reach statistical significance. Improvements in QOL were observed despite alterations in thyroid axis.Conclusion: Changes in the thyroid axis following GH replacement are associated with complex tissue-specific effects. These fluctuations may induce a hypothyroid phenotype in some tissues while appearing to improve the biological action of thyroid hormone in other organs.Abbreviations: AGHDA = Assessment of Growth Hormone Deficiency in Adulthood; CHOox = carbohydrate oxidation; ET = ejection time; fT3 = free triiodothyronine; fT4 = free thyroxine; GH = growth hormone; GHD = growth hormone deficiency; HB-RQ = high baseline respiratory quotient; HPT = hypothalamic-pituitary-thyroid; ICT = isovolumetric contraction time; IGF-1 = insulin-like growth factor 1; IRT = isovolumetric relaxation time; LB-RQ = low baseline respiratory quotient; LV = left ventricular; NHP = Nottingham Health Profile; QOL = quality of life; REE = resting energy expenditure; RQ = respiratory quotient; rT3 = reverse triiodothyronine; SF-36 = Short Form 36; TSH = thyroid-stimulating hormone; T3 = triiodothyronine; T4 = thyroxine; TT3 = total triiodothyronine; TT4 = total thyroxine     

Association between Decreased Klotho Blood Levels and Organic Growth Hormone Deficiency in Children with Growth Impairment

Objective

Klotho is an aging-modulating protein expressed mainly in the kidneys and choroid plexus, which can also be shed, released into the circulation and act as a hormone. Klotho deficient mice are smaller compared to their wild-type counterparts and their somatotropes show marked atrophy and reduced number of secretory granules. Recent data also indicated an association between klotho levels and growth hormone (GH) levels in acromegaly. We aimed to study the association between klotho levels and GH deficiency (GHD) in children with growth impairment.

Design

Prospective study comprising 99 children and adolescents (aged 9.0±3.7 years, 49 male) undergoing GH stimulation tests for short stature (height-SDS = −2.1±0.6). Klotho serum levels were measured using an α-klotho ELISA kit.

Results

Klotho levels were significantly lower (p<0.001) among children with organic GHD (n = 11, 727±273 pg/ml) compared to both GH sufficient participants (n = 59, 1497±754 pg/ml) and those with idiopathic GHD (n = 29, 1645±778 pg/ml). The difference between GHS children and children with idiopathic GHD was not significant. Klotho levels positively correlated with IGF-1- standard deviation scores (SDS) (R = 0.45, p<0.001), but were not associated with gender, pubertal status, age or anthropometric measurements.

Conclusions

We have shown, for the first time, an association between low serum klotho levels and organic GHD. If validated by additional studies, serum klotho may serve as novel biomarker of organic GHD.     

Influence of Nonthyroidal Illnesses on Serum Thyroid Hormone Indices in Hyperthyroidism

Severe intercurrent nonthyroidal illnesses (diabetic ketoacidosis, myocardial infarction, fulminant hepatitis and bacterial pneumonia) in four thyrotoxic patients were associated with depression of total serum thyroxine (T₄) and triiodothyronine (T₃) values into the normal or even subnormal range. A diagnosis of hyperthyroidism was established by a combination of elevated radioactive iodine uptake, absent thyroid-stimulating hormone response to thyrotropin-releasing hormone or an elevated free T₄ by dialysis values. In the two of four cases that had a fatal outcome, there was a progressive decline in total T₄ and total T₃ values. In contrast, the two surviving patients had a progressive increase of total T₃ and total T₄ values into the hyperthyroid range as their underlying illness resolved. As has been seen with severe nonthyroidal illnesses, pronounced depression of total T₃ and total T₄ levels in hyperthyroid patients may also portend a poor prognosis.     

Serum Growth Hormone Levels and the Response of Diabetic Retinopathy to Pituitary Ablation

Serum growth hormone levels were measured during insulin tolerance tests in 36 patients after yttrium-90 pituitary implantation for diabetic retinopathy. The response of the new blood vessels was more clearly related to loss of growth hormone function than was the improvement of retinal haemorrhages and microaneurysms. The overall response of the retinopathy was greatest when growth hormone function was lost.Since the loss of growth hormone function was related to the loss of other aspects of anterior pituitary function, a unique role of growth hormone in the response of diabetic retinopathy to pituitary ablation could not be established.     

Multiple Component Analysis of Plasma Growth Hormone in Children with Standard and Short Stature

Growth hormone (GH) concentrations (in ng/ml) were determined by radioimmunoassay, in plasma obtained at about 3-hr intervals during a 24-hr sampling span, from 42 boys and 12 girls of short stature (2-4 standard deviations below their peer group mean), and 13 boys and 9 girls of standard stature. Subjects had 11.20 0.37 years of age at the time of study, and were living on a diurnal waking (∼07:30 to ∼22:30), nocturnal resting routine during sampling. Analysis of these data by single and population-mean cosinor methods as well as by analysis of variance revealed circadian and ultradian prominent components characterizing most groups. Accordingly, a multiple component analysis was undertaken for data of each group separately, as well as for all subjects. A comparison of circadian parameters indicates similar characteristics between short and standard children, whether one compares boys [P=0.674, 0.371 and 0.749 for comparison of rhythm adjusted means (M), amplitudes (A) and acrophases (), respectively], girls (P=0.993,0.914 and 0.397), or all children (P=0.859,0.712 and 0.865). Differences are found, however, in circasemidian characteristics as well as in the prominent 8-hr ultradian component documented for the short but not for the standard children. These ultradian components should be taken into consideration in the design and later evaluation of a time-specified treatment of children of short stature.     

脑钠肽与急性心肌梗死的研究进展

脑钠肽是心肌细胞分泌的一种循环激素。左心室的牵张和心室壁张力的增加对BNP的合成和分泌起主要调节作用;心肌缺血也是BNP释放的重要触发因素之一。对BNP水平进行分级能够很好的对急性心肌梗死进行危险分层,对诊断、预后的评估有重要意义。本文就脑钠肽的特性及与心肌梗死的关系做一综述。     

Growth Hormone Release Inhibiting Hormone in Acromegaly

Growth hormone release inhibiting hormone (GHRIH) was administered by constant infusion over 75 minutes to eight acromegalic patients at different doses. 100 to 1,000 μg were equally effective in reducing circulating growth hormone (GH) levels; 25 μg lowered GH levels in only five patients, and at this dose the extent of the fall was smaller than from doses of 100 μg or more. 10 μg was ineffective. Injection of single doses of 500 μg by intravenous, subcutaneous, and intramuscular routes caused only small and transient reductions in GH levels, though the effect was improved by injecting the hormone intramuscularly in 2 ml of 16% gelatin. Injection of a suspension of 4 mg GHRIH in 1 ml of arachis oil lowered growth hormone levels for between three and four hours.In four acromegalic patients an oral 50-g glucose tolerance test was performed during a continuous infusion of either saline or 1,000 μg GHRIH. The “paradoxical” rise in growth hormone seen in these patients during the saline infusion was suppressed by GHRIH. The blood glucose responses were, moreover, modified by GHRIH in that the peak was delayed and occurred at the end of the infusion in each case. A “normal” glucose tolerance curve was converted to a “diabetic” type of response in two patients. This effect could be accounted for by the inhibition of insulin secretion known to occur with large doses of GHRIH.We speculate that acromegaly may be primarily a hypothalmic disease due to deficiency of GHRIH resulting in excessive secretion of growth hormone from the pituitary and adenoma formation due to inappropriate and prolonged stimulation of the pituitary.     

Higher Growth Hormone Levels are Associated with Erectile Dysfunction in Male Patients With Acromegaly

Objective: To investigate in vivo correlates of erectile dysfunction (ED) in male patients with acromegaly.Methods: Fifty-one male patients with acromegaly were assessed by the International Index of Erectile Function-5 and Acromegaly Quality of Life (Acro-QoL) questionnaires. The measurement of serum nitric oxide (NO) were performed in patients and age-matched nonacromegalic controls.Results: Among 51 patients analyzed, 32 (62.7%) had ED. Patients with ED showed lower Acro-QoL scores regarding global (69.8 ± 17.7 versus 79.4 ± 11.2; P = .035) and personal relationship dimensions (59.6 ± 22.1 versus 76.8 ± 17.6; P = .012) than non-ED patients. ED patients were older (44.5 ± 11.2 years versus 33.2 ± 8.5 years; P = .04) and showed higher growth hormone (GH) levels (15.5 μg/L &lsqb;interquartile range of 9.5 to 34.5 μg/L] versus 5.9 μg/L &lsqb;interquartile range of 3.4 to 13.9 μg/L]; P = .001) compared to non-ED patients. The cutoff values for identifying ED were 7.9 μg/L for random GH and 5.3 μg/L for GH nadir after oral administration of 75 g of glucose. There was no significant difference in total testosterone levels between the two groups (6.36 ± 4.24 nmol/L versus 9.54 ± 5.50 nmol/L; P = .299). The NO levels in patients with acromegaly were significantly lower than those in nonacromegalic controls (8.77 ± 1.78 μmol/L versus 19.19 ± 5.02 μmol/L, respectively; P = .049). Furthermore, the NO levels were even lower in ED patients than those in non-ED patients (5.14 ± 0.98 μmol/L versus 12.09 ± 3.44 μmol/L; P = .027).Conclusion: Our study showed that ED is prevalent in male acromegalic patients and may be associated with systemic endothelial dysfunction induced by excessive GH. Further studies investigating the mechanism of GH and ED are required.Abbreviations: Acro-QoL = Acromegaly Quality of Life; ED = erectile dysfunction; FSH = follicle-stimulating hormone; GH = growth hormone; IGF-1 = insulin-like growth factor 1; IIEF-5 = international index of erection function-5; LH = luteinizing hormone; MRI = magnetic resonance imaging; NO = nitric oxide; OGTT = oral glucose tolerance test; QoL = quality of life; ROC = receiver operating characteristic     

Plasma Steroid and Luteinizing Hormone Levels during Prostaglandin F2α Administration in Luteal Phase of Menstrual Cycle

An intravenous infusion of prostaglandin F₂α (12.5-250μg/min) was administered in four volunteers in the mid-late luteal phase and three in the early luteal phase of the menstrual cycle.Frequent measurement of plasma progesterone, oestrogens, and luteinizing hormone (LH) showed that administration of high doses depressed plasma progesterone levels in the late luteal phase and caused concomitant side effects. Levels of progesterone in the early luteal phase were unaffected. In both phases oestrogen and LH levels were little altered. In two subjects, hourly progesterone levels measured throughout the day at a similar time in a subsequent control menstrual cycle showed an appreciable variation in one but steady levels in the second. This variation may contribute to the magnitude of the fall in progesterone noted during the infusion of prostaglandins.     

Association between Serum Growth Hormone Levels and Nonalcoholic Fatty Liver Disease: A Cross-Sectional Study

Growth hormone (GH) is an important regulator of metabolism and body composition. GH deficiency is associated with increased visceral body fat and other features of the metabolic syndrome. Here we performed a cross-sectional study to explore the association of GH levels with nonalcoholic fatty liver disease (NAFLD), which is considered to be the hepatic manifestation of the metabolic syndrome. A total of 1,667 subjects were diagnosed as NAFLD according the diagnostic criteria, and 5,479 subjects were defined as the controls. The subjects with NAFLD had significantly lower levels of serum GH than the controls. Those with low GH levels had a higher prevalence of NAFLD and the metabolic syndrome. A stepwise logistic regression analysis showed that GH levels were significantly associated with the risk factor for NAFLD (OR = 0.651, 95%CI = 0.574–0.738, P<0.001). Our results showed a significant association between lower serum GH levels and NAFLD.     

生长激素和生长激素受体的分子生物学

1 .生长激素的结构生长激素 (ｇｒｏｗｔｈｈｏｒｍｏｎｅ ,ＧＨ)一般含有 1 91个氨基酸 ,约 2 2ｋＤ。猪与牛的ＧＨ氨基酸序列具有高度的同源性 (约 90 % ) [1] 。猪和牛的ＧＨ对人没有促进生长的作用 ,可能是猪和牛ＧＨ对人的生长激素受体(ｇｒｏｗｔｈｈｏｒｍｏｎｅｒｅｃｅｐｔｏｒ ,ＧＨＲ )的结合亲和性低于人ＧＨ对人ＧＨＲ的结合亲和性的缘故。ＧＨｍＲＮＡ翻译的初级产物是前生长激素 ,它比成熟ＧＨ在Ｎ端多出 2 6个氨基酸残基的疏水信号肽[2 ] 。通过Ｘ射线衍射技术等研究发现 ,ＧＨ由 4个螺旋组成 ,自Ｎ端至Ｃ端依次为螺旋 1～ …     

Correlative Changes in Endogenous Hormone Levels and Shoot Growth Induced by Short Heat Treatments to the Root

Heat treatments of two minutes at 46 to 47°C to root systems of Nicotiana rustica and Phaseolus vulgaris affected roots and shoots. Xylem exudate of Phaseolus was collected, and it was found that heat treatment reduced cytokinin levels and increased abscisic acid levels in the exudate. Shoot and root growth of both species was reduced. Root membrane integrity of Nicotiana was measured and was found to be impaired. It is suggested that the changes in hormone activity due to heat treatment regulate the reduction in shoot growth. Cell wall metabolism and glucosyl transferases making β-glucans were investigated in Phaseolus leaves. Incorporation of ¹⁴C from ¹⁴CO₂ into wall constituents was slightly inhibited but neither photosynthesis nor extracted β-glucan synthetases were affected during the first 12 hours after treatment.