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Children with Organic Growth Hormone Deficiency Have Elevated Cortisol Responses to Stimuli

Departments of Biobehavioral Health (J.W.F., D.E.R., E.G.) and Health Policy and Administration (S.F.), College of Health and Human Development, and Department of Pediatrics (J.W.F., H.E.K., M.R.D.), College of Medicine, The Pennsylvania State University, University Park, Pennsylvania 16802; and Kaunas University of Medicine, Institute of Endocrinology (R.K.), Kaunas, Lithuania

Address correspondence and requests for reprints to: Jordan W. Finkelstein, M.D., The Pennsylvania State University, E 315 HHDEV, University Park, Pennsylvania 16802. E-mail: jwf3{at}psu.edu

Abstract

The aim of this study was to investigate hypothalamic-pituitary-adrenal (HPA) function in children with GH deficiency. Ninety-four patients were evaluated for GH deficiency and cortisol (F) deficiency using clinical criteria and L-dopa and insulin-induced hypoglycemia stimulation tests. They were assigned to three diagnostic groups: organic GH deficient (OGHD), idiopathic GH deficient (IGHD), and not GH-deficient (NGHD). Time series, cross-sectional, regression analysis revealed statistically significantly elevated F [>828 nmol/L (30 µg/dL)] in the OGHD group vs. the NGHD group. The value for F in the IGHD group was not different from the NGHD group. This finding suggests that dysregulation of the HPA axis is present in most children with OGH deficiency and significantly less often in children with IGH deficiency or without GH deficiency. Anatomical disruption of the control pathways for the HPA axis or stress may cause the dysregulation.