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Growth Hormone Release in Response to Human Pancreatic Tumor Growth Hormone-Releasing Hormone-40 in Children with Short Stature^*

Departments of Pediatrics The University of Virginia School of Medicine, Charlottesville, Virginia 22908
Pharmacology The University of Virginia School of Medicine, Charlottesville, Virginia 22908
Internal Medicine The University of Virginia School of Medicine, Charlottesville, Virginia 22908
The Department of Pediatrics Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104
Peptide Biology Laboratory The Salk Institute, San Diego, California 92138

Address all correspondence and requests for reprints to: Alan D. Rogol, M.D., Ph.D., Box 386, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia 22908.

Forty children with short stature were evaluated for GH reserve after pharmacological tests and after a single iv injection of human pancreatic tumor GH-releasing hormone ((hpGRH-40). These children were grouped into four diagnostic categories: 1) idiopathic GH deficiency (n = 10); 2) organic hypopituitarism (n = 7); 3) intrauterine growth retardation (n = 5); and 4) constitutional delay of growth and/or familial short stature (n = 18), by standard clinical criteria and physiological and pharmacological tests of GH reserve.

Venous blood was sampled for GH concentrations on 2 consecutive days: on day 1, after the iv administration of L-arginine (0.5 g/kg for 30 min) and oral administration of L-dopa (9 mg/kg), and on day 2, after the administration of hpGRH-40, 3.3 µg/kg, as an iv bolus.

No GH-deficient patient in categories 1 or 2 increased his/her circulating GH concentration to more than 7 ng/ml after the arginine-L-dopa test; however, six children had marked GH responses after hpGRH-40 administration. As a group the lowest peak responses (mean ± SE) to GRH were found in the organic hypopituitary (3.4 ± 1.1 ng/ml) and in the idiopathic GH deficiency (8.2 ± 2.4 ng/ml) categories. All children in the intrauterine growth retardation and constitutional delay of growth (controls for the GH-deficient children) responded briskly to hpGRH-40, although there was wide variation of the peak GH levels (5–51 ng/ml). Circulating concentrations of somatomedin-C did not differ in subjects in any category 24 h after hpGRH-40 injection when compared to basal values. These data indicate that hpGRH-40 can be employed to evaluate GH reseve in short children and may be useful in the diagnosis of hypothalamicpituitary disorders.

^* These studies were supported in part by USPHS Research Grants: General Clinical Research Grant RR-847; Grants HD-13197 and AM-32632 (To M.O.T.); CIA 1-KO3-HD00439 (to W.S.E.); and Grants AM-26741; AM-20917, and HD-13527 (to the Peptide Biology Laboratory).

Received February 27, 1984.

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