Primary hyperparathyroidism is associated with marked impairment of GH response to acylated ghrelin. Clin Endocrinol (Oxf) 2008 Aug;69(2):197-201
Date
01/29/2008Pubmed ID
18221398DOI
10.1111/j.1365-2265.2008.03188.xScopus ID
2-s2.0-47549105972 (requires institutional sign-in at Scopus site) 4 CitationsAbstract
BACKGROUND: Impaired GH secretion is a common finding in patients with primary hyperparathyroidism (PHP). Ghrelin displays strong GH-releasing action, mainly at the hypothalamic level.
OBJECTIVE: To evaluate secretory response of GH to ghrelin in PHP patients.
PATIENTS: Fifteen patients [11 women/4 men, mean age 54 years, range 32-70 years, body mass index (BMI) 25.0 +/- 0.7 kg/m(2)] affected with PHP due to single parathyroid adenoma and 35 normal age-matched subjects (23 women/12 men, mean age 58 years, range 35-68 years, BMI 24.1 +/- 1.1 kg/m(2)).
METHODS: A measure of 1 microg/kg body weight i.v. acylated ghrelin or 1 microg/kg body weight i.v. GH releasing hormone (GHRH) followed by 0.5 g/kg body weight i.v. arginine (ARG) hydrochloride were administered to all subjects on alternate days in order to evaluate GH response.
RESULTS: Mean serum GH peak after GHRH + ARG was 32.6 +/- 7.8 and 17.4 +/- 4.0 microg/l, in controls and PHP patients, respectively (P < 0.05). Mean serum GH peak after ghrelin was 70.4 +/- 31.5 and 16.8 +/- 1.9 microg/l, in controls and PHP patients, respectively, (P < 0.001). Using ROC curves, a serum GH peak > 22 microg/l after ghrelin stimulation might be considered as a cut-off value for identifying normal subjects. Ten (67%) PHP patients have impaired GH response to GHRH + ARG and 13 (87%) to ghrelin. Serum GH peak after ghrelin or GHRH + ARG was unrelated to serum IGF-1, PTH or ionized calcium concentrations.
CONCLUSIONS: The present data confirm that GH secretion is impaired in PHP patients using the potent GH secretagogue ghrelin and suggest that impaired GH secretion is likely due to a deleterious effect of hypercalcaemia at the hypothalamic level in PHP patients.
Author List
Cecconi E, Bogazzi F, Morselli LL, Gasperi M, Procopio M, Gramaglia E, Broglio F, Giovannetti C, Ghigo E, Martino EAuthor
Lisa Morselli MD, PhD Assistant Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AcylationAdenoma
Adult
Aged
Diagnostic Techniques, Endocrine
Female
Ghrelin
Human Growth Hormone
Humans
Hyperparathyroidism, Primary
Injections, Intravenous
Male
Middle Aged
Parathyroid Neoplasms
Secretory Pathway
Sensitivity and Specificity