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Peak and Trough Growth Hormone Concentrations Have Different Associations with the Insulin-Like Growth Factor Axis, Body Composition, and Metabolic Parameters¹

London Centre for Paediatric Endocrinology and Metabolism at University College London (P.C.H., P.J.P., C.G.D.B.), Cobbold Laboratories, Middlesex Hospital, London W1N 8AA; and Medical Research Council Environmental Epidemiology Unit (C.H.D.F., C.O.), University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, United Kingdom.

Address all correspondence and requests for reprints to: Dr. P. C. Hindmarsh, London Centre for Paediatric Endocrinology and Metabolism, Cobbold Laboratories, Middlesex Hospital, Mortimer Street, London W1N 8AA, United Kingdom. E-mail: p.hindmarsh{at}med.ucl.ac.uk

GH is secreted in a pulsatile fashion, promoting growth and anabolism. The components of the pulsatile signal involved in these diverse effects are unclear. We constructed (20-min sampling interval) and analyzed 24-h serum GH profiles in 45 adult male volunteers, 59.4–69.9 yr old, body mass index (BMI) 21.9–36.5 Kg/m², using Fourier transformation and a concentration distribution analysis that determines the concentration at or below which the serum GH concentrations in the 24-h profile spend a percentage of the total time. The observed concentrations (OC) below which 95% and 5% of the values in the time series lie [lsb]OC95 (peaks) and OC5 (troughs)] and mean 24-h serum GH concentrations were related to measures of the insulin-like growth factor (IGF) family, parameters of body composition, fasting insulin and cholesterol measures, and GH-binding protein concentrations.

Mean 24-h serum GH concentrations ranged between 0.19 and 2.15 mU/L (1 µg/L = 2.6 mU/L). Pulse periodicity was between 180 and 200 min. There was a positive relationship between peak GH levels and serum IGF-1 and IGFBP-3 levels (r = 0.39; P = 0.009 and r = 0.32; P = 0.03, respectively). GH trough levels were unrelated to these measures of the IGF family. In contrast, GH troughs were related inversely to BMI (r = -0.31; P = 0.04) and waist-hip ratio (r = -0.4; P = 0.006). Peak GH levels were not related to these measures. Factors known to influence these measures, fasting insulin concentration, or cortisol secretion did not alter the trough GH relationship in multiple regression analysis. All GH parameters were related inversely to fasting insulin concentration. Although GH parameters were related inversely to cholesterol and low-density lipoprotein-cholesterol, this effect disappeared when age and fasting insulin levels were introduced into the regression. GH-binding protein levels related most strongly to BMI (r = 0.60; P < 0.001), with no effect of any GH parameter observed in multiple regression analysis. These results suggest that the peak values of a GH concentration profile may influence the IGF axis, whereas trough values may influence body composition and metabolic parameters of GH action.

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