The growth hormone (GH) response to the arginine plus GH-releasing hormone test is correlated to the severity of lipid profile abnormalities in adult patients with GH deficiency

Annamaria Colao, Gaetana Cerbone, Rosario Pivonello, Gianluca Aimaretti, Sandro Loche, Carolina Di Somma, Antongiulio Faggiano, Ginevra Corneli, Ezio Ghigo, Gaetano Lombardi

Research output: Contribution to journalArticle

Abstract

The aim of the present study was to correlate the degree of the GH response to the combined arginine and GHRH (ARG+GHRH) test with clinical status in 157 adult hypopituitary patients and 35 healthy controls. On the basis of the GH response to ARG+GHRH, the 192 subjects were subdivided into 5 groups: group 1, very severe GH deficiency (GHD; 65 patients with GH peak 16.5 μg/L); and group 5 (35 controls with GH peak >16.5 μg/L). Plasma insulin-like growth factor I (IGF-I) concentrations were lower (P <0.001) in patients of group i (74.4 ± 6.7 μg/L) and group 2 (81.4 ± 6.8 μg/L) than in those of group 3, 4, and 5 (163.6 ± 40.6, 185.9 ± 21, and 188.8 ± 11.1 μg/L, respectively). Plasma IGF-binding protein-3 concentrations were lower (P <0.01) in group 1 (2.1 ± 0.2 mg/L) and group 2 (2.0 ± 0.2 mg/L) than in group 3 (3.4 ± 0.7 mg/L) and group 5 (3.8 ± 0.2 mg/L). In patients of group 1, total cholesterol (228.3 ± 5.7 mg/dL) and triglycerides levels (187.4 ± 15.3 mg/dL) were higher than those in group 3 (196.6 ± 9.6 and 115.8 ± 10.1 mg/dL, respectively), group 4 (176.8 ± 11.3 and 101.4 ± 12.5 mg/dL, respectively), and group 5 (160 ± 6.9 and 99.3 ± 5.4 mg/dL, respectively). High density lipoprotein cholesterol levels were lower in patients of group 1 (45.2 ± 2.4 mg/dL) than in those of group 4 (54.7 ± 3.5 mg/dL; P <0.05) and group 5 (53.6 ± 2 mg/dL; P <0.001), whereas low density lipoprotein cholesterol levels were higher in patients of group 1 (127.3 ± 7.9 mg/dL), group 2 (129.2 ± 9.5 mg/dL), and 3 (133 ± 9 mg/dL) than in those of group 5 (102.4 ± 7.4 mg/dL; P <0.05). Patients of group 2 had total cholesterol, high density lipoprotein cholesterol, and triglycerides levels at an intermediate level with respect to those in groups 1, 3, and 4. Among the five groups, no difference was found in fasting glucose concentrations, heart rate, or systolic and diastolic blood pressures. A significant increase in fat body mass and a decrease in lean body mass and total body water were found in all patients compared to controls. Disease duration was significantly shorter in patients of group 4 than in those of the remaining three groups (P <0.001). A significant correlation was found between the GH peak after ARG+GHRH and disease duration (r = -0.401; P <0.001), plasma IGF-I (r = 0.434; P <0.001), total cholesterol (r = -0.324; P <0.001), and triglycerides levels (r = -0.219; P <0.05). A significant multiple linear regression coefficient was found between the GH peak after ARG+GHRH and plasma IGF-I levels (t = 2.947; P <0.005), total cholesterol levels (t = -2.746; P <0.01), and disease duration (t = -2.397; P <0.05). In conclusion, the results of the present study indicate that the degree of the GH response to ARG+GHRH is correlated with the severity of lipid profile abnormalities and substantiate the reliability of the ARG+GHRH test for the diagnosis of GHD in adults. Because at present GH treatment is recommended only in adult patients with severe GHD, patients with a GH response below 9 μg/L to the ARG+GHRH test should be treated with GH, as should patients with a peak GH response to an insulin tolerance test below 3 μg/L.

Original languageEnglish
Pages (from-to)1277-1282
Number of pages6
JournalJournal of Clinical Endocrinology and Metabolism
Volume84
Issue number4
Publication statusPublished - 1999

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Growth Hormone-Releasing Hormone
Growth Hormone
Arginine
Lipids
Insulin-Like Growth Factor I
Cholesterol
Plasmas
HDL Cholesterol
Triglycerides
Blood Pressure
Insulin-Like Growth Factor Binding Protein 3
Fat Body
Body Water
Blood pressure
Linear regression
LDL Cholesterol
Blood Proteins
Linear Models
Fasting
Heart Rate

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

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The growth hormone (GH) response to the arginine plus GH-releasing hormone test is correlated to the severity of lipid profile abnormalities in adult patients with GH deficiency. / Colao, Annamaria; Cerbone, Gaetana; Pivonello, Rosario; Aimaretti, Gianluca; Loche, Sandro; Di Somma, Carolina; Faggiano, Antongiulio; Corneli, Ginevra; Ghigo, Ezio; Lombardi, Gaetano.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 84, No. 4, 1999, p. 1277-1282.

Research output: Contribution to journalArticle

Colao, Annamaria ; Cerbone, Gaetana ; Pivonello, Rosario ; Aimaretti, Gianluca ; Loche, Sandro ; Di Somma, Carolina ; Faggiano, Antongiulio ; Corneli, Ginevra ; Ghigo, Ezio ; Lombardi, Gaetano. / The growth hormone (GH) response to the arginine plus GH-releasing hormone test is correlated to the severity of lipid profile abnormalities in adult patients with GH deficiency. In: Journal of Clinical Endocrinology and Metabolism. 1999 ; Vol. 84, No. 4. pp. 1277-1282.
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title = "The growth hormone (GH) response to the arginine plus GH-releasing hormone test is correlated to the severity of lipid profile abnormalities in adult patients with GH deficiency",
abstract = "The aim of the present study was to correlate the degree of the GH response to the combined arginine and GHRH (ARG+GHRH) test with clinical status in 157 adult hypopituitary patients and 35 healthy controls. On the basis of the GH response to ARG+GHRH, the 192 subjects were subdivided into 5 groups: group 1, very severe GH deficiency (GHD; 65 patients with GH peak 16.5 μg/L); and group 5 (35 controls with GH peak >16.5 μg/L). Plasma insulin-like growth factor I (IGF-I) concentrations were lower (P <0.001) in patients of group i (74.4 ± 6.7 μg/L) and group 2 (81.4 ± 6.8 μg/L) than in those of group 3, 4, and 5 (163.6 ± 40.6, 185.9 ± 21, and 188.8 ± 11.1 μg/L, respectively). Plasma IGF-binding protein-3 concentrations were lower (P <0.01) in group 1 (2.1 ± 0.2 mg/L) and group 2 (2.0 ± 0.2 mg/L) than in group 3 (3.4 ± 0.7 mg/L) and group 5 (3.8 ± 0.2 mg/L). In patients of group 1, total cholesterol (228.3 ± 5.7 mg/dL) and triglycerides levels (187.4 ± 15.3 mg/dL) were higher than those in group 3 (196.6 ± 9.6 and 115.8 ± 10.1 mg/dL, respectively), group 4 (176.8 ± 11.3 and 101.4 ± 12.5 mg/dL, respectively), and group 5 (160 ± 6.9 and 99.3 ± 5.4 mg/dL, respectively). High density lipoprotein cholesterol levels were lower in patients of group 1 (45.2 ± 2.4 mg/dL) than in those of group 4 (54.7 ± 3.5 mg/dL; P <0.05) and group 5 (53.6 ± 2 mg/dL; P <0.001), whereas low density lipoprotein cholesterol levels were higher in patients of group 1 (127.3 ± 7.9 mg/dL), group 2 (129.2 ± 9.5 mg/dL), and 3 (133 ± 9 mg/dL) than in those of group 5 (102.4 ± 7.4 mg/dL; P <0.05). Patients of group 2 had total cholesterol, high density lipoprotein cholesterol, and triglycerides levels at an intermediate level with respect to those in groups 1, 3, and 4. Among the five groups, no difference was found in fasting glucose concentrations, heart rate, or systolic and diastolic blood pressures. A significant increase in fat body mass and a decrease in lean body mass and total body water were found in all patients compared to controls. Disease duration was significantly shorter in patients of group 4 than in those of the remaining three groups (P <0.001). A significant correlation was found between the GH peak after ARG+GHRH and disease duration (r = -0.401; P <0.001), plasma IGF-I (r = 0.434; P <0.001), total cholesterol (r = -0.324; P <0.001), and triglycerides levels (r = -0.219; P <0.05). A significant multiple linear regression coefficient was found between the GH peak after ARG+GHRH and plasma IGF-I levels (t = 2.947; P <0.005), total cholesterol levels (t = -2.746; P <0.01), and disease duration (t = -2.397; P <0.05). In conclusion, the results of the present study indicate that the degree of the GH response to ARG+GHRH is correlated with the severity of lipid profile abnormalities and substantiate the reliability of the ARG+GHRH test for the diagnosis of GHD in adults. Because at present GH treatment is recommended only in adult patients with severe GHD, patients with a GH response below 9 μg/L to the ARG+GHRH test should be treated with GH, as should patients with a peak GH response to an insulin tolerance test below 3 μg/L.",
author = "Annamaria Colao and Gaetana Cerbone and Rosario Pivonello and Gianluca Aimaretti and Sandro Loche and {Di Somma}, Carolina and Antongiulio Faggiano and Ginevra Corneli and Ezio Ghigo and Gaetano Lombardi",
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T1 - The growth hormone (GH) response to the arginine plus GH-releasing hormone test is correlated to the severity of lipid profile abnormalities in adult patients with GH deficiency

AU - Colao, Annamaria

AU - Cerbone, Gaetana

AU - Pivonello, Rosario

AU - Aimaretti, Gianluca

AU - Loche, Sandro

AU - Di Somma, Carolina

AU - Faggiano, Antongiulio

AU - Corneli, Ginevra

AU - Ghigo, Ezio

AU - Lombardi, Gaetano

PY - 1999

Y1 - 1999

N2 - The aim of the present study was to correlate the degree of the GH response to the combined arginine and GHRH (ARG+GHRH) test with clinical status in 157 adult hypopituitary patients and 35 healthy controls. On the basis of the GH response to ARG+GHRH, the 192 subjects were subdivided into 5 groups: group 1, very severe GH deficiency (GHD; 65 patients with GH peak 16.5 μg/L); and group 5 (35 controls with GH peak >16.5 μg/L). Plasma insulin-like growth factor I (IGF-I) concentrations were lower (P <0.001) in patients of group i (74.4 ± 6.7 μg/L) and group 2 (81.4 ± 6.8 μg/L) than in those of group 3, 4, and 5 (163.6 ± 40.6, 185.9 ± 21, and 188.8 ± 11.1 μg/L, respectively). Plasma IGF-binding protein-3 concentrations were lower (P <0.01) in group 1 (2.1 ± 0.2 mg/L) and group 2 (2.0 ± 0.2 mg/L) than in group 3 (3.4 ± 0.7 mg/L) and group 5 (3.8 ± 0.2 mg/L). In patients of group 1, total cholesterol (228.3 ± 5.7 mg/dL) and triglycerides levels (187.4 ± 15.3 mg/dL) were higher than those in group 3 (196.6 ± 9.6 and 115.8 ± 10.1 mg/dL, respectively), group 4 (176.8 ± 11.3 and 101.4 ± 12.5 mg/dL, respectively), and group 5 (160 ± 6.9 and 99.3 ± 5.4 mg/dL, respectively). High density lipoprotein cholesterol levels were lower in patients of group 1 (45.2 ± 2.4 mg/dL) than in those of group 4 (54.7 ± 3.5 mg/dL; P <0.05) and group 5 (53.6 ± 2 mg/dL; P <0.001), whereas low density lipoprotein cholesterol levels were higher in patients of group 1 (127.3 ± 7.9 mg/dL), group 2 (129.2 ± 9.5 mg/dL), and 3 (133 ± 9 mg/dL) than in those of group 5 (102.4 ± 7.4 mg/dL; P <0.05). Patients of group 2 had total cholesterol, high density lipoprotein cholesterol, and triglycerides levels at an intermediate level with respect to those in groups 1, 3, and 4. Among the five groups, no difference was found in fasting glucose concentrations, heart rate, or systolic and diastolic blood pressures. A significant increase in fat body mass and a decrease in lean body mass and total body water were found in all patients compared to controls. Disease duration was significantly shorter in patients of group 4 than in those of the remaining three groups (P <0.001). A significant correlation was found between the GH peak after ARG+GHRH and disease duration (r = -0.401; P <0.001), plasma IGF-I (r = 0.434; P <0.001), total cholesterol (r = -0.324; P <0.001), and triglycerides levels (r = -0.219; P <0.05). A significant multiple linear regression coefficient was found between the GH peak after ARG+GHRH and plasma IGF-I levels (t = 2.947; P <0.005), total cholesterol levels (t = -2.746; P <0.01), and disease duration (t = -2.397; P <0.05). In conclusion, the results of the present study indicate that the degree of the GH response to ARG+GHRH is correlated with the severity of lipid profile abnormalities and substantiate the reliability of the ARG+GHRH test for the diagnosis of GHD in adults. Because at present GH treatment is recommended only in adult patients with severe GHD, patients with a GH response below 9 μg/L to the ARG+GHRH test should be treated with GH, as should patients with a peak GH response to an insulin tolerance test below 3 μg/L.

AB - The aim of the present study was to correlate the degree of the GH response to the combined arginine and GHRH (ARG+GHRH) test with clinical status in 157 adult hypopituitary patients and 35 healthy controls. On the basis of the GH response to ARG+GHRH, the 192 subjects were subdivided into 5 groups: group 1, very severe GH deficiency (GHD; 65 patients with GH peak 16.5 μg/L); and group 5 (35 controls with GH peak >16.5 μg/L). Plasma insulin-like growth factor I (IGF-I) concentrations were lower (P <0.001) in patients of group i (74.4 ± 6.7 μg/L) and group 2 (81.4 ± 6.8 μg/L) than in those of group 3, 4, and 5 (163.6 ± 40.6, 185.9 ± 21, and 188.8 ± 11.1 μg/L, respectively). Plasma IGF-binding protein-3 concentrations were lower (P <0.01) in group 1 (2.1 ± 0.2 mg/L) and group 2 (2.0 ± 0.2 mg/L) than in group 3 (3.4 ± 0.7 mg/L) and group 5 (3.8 ± 0.2 mg/L). In patients of group 1, total cholesterol (228.3 ± 5.7 mg/dL) and triglycerides levels (187.4 ± 15.3 mg/dL) were higher than those in group 3 (196.6 ± 9.6 and 115.8 ± 10.1 mg/dL, respectively), group 4 (176.8 ± 11.3 and 101.4 ± 12.5 mg/dL, respectively), and group 5 (160 ± 6.9 and 99.3 ± 5.4 mg/dL, respectively). High density lipoprotein cholesterol levels were lower in patients of group 1 (45.2 ± 2.4 mg/dL) than in those of group 4 (54.7 ± 3.5 mg/dL; P <0.05) and group 5 (53.6 ± 2 mg/dL; P <0.001), whereas low density lipoprotein cholesterol levels were higher in patients of group 1 (127.3 ± 7.9 mg/dL), group 2 (129.2 ± 9.5 mg/dL), and 3 (133 ± 9 mg/dL) than in those of group 5 (102.4 ± 7.4 mg/dL; P <0.05). Patients of group 2 had total cholesterol, high density lipoprotein cholesterol, and triglycerides levels at an intermediate level with respect to those in groups 1, 3, and 4. Among the five groups, no difference was found in fasting glucose concentrations, heart rate, or systolic and diastolic blood pressures. A significant increase in fat body mass and a decrease in lean body mass and total body water were found in all patients compared to controls. Disease duration was significantly shorter in patients of group 4 than in those of the remaining three groups (P <0.001). A significant correlation was found between the GH peak after ARG+GHRH and disease duration (r = -0.401; P <0.001), plasma IGF-I (r = 0.434; P <0.001), total cholesterol (r = -0.324; P <0.001), and triglycerides levels (r = -0.219; P <0.05). A significant multiple linear regression coefficient was found between the GH peak after ARG+GHRH and plasma IGF-I levels (t = 2.947; P <0.005), total cholesterol levels (t = -2.746; P <0.01), and disease duration (t = -2.397; P <0.05). In conclusion, the results of the present study indicate that the degree of the GH response to ARG+GHRH is correlated with the severity of lipid profile abnormalities and substantiate the reliability of the ARG+GHRH test for the diagnosis of GHD in adults. Because at present GH treatment is recommended only in adult patients with severe GHD, patients with a GH response below 9 μg/L to the ARG+GHRH test should be treated with GH, as should patients with a peak GH response to an insulin tolerance test below 3 μg/L.

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