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Variability in the growth hormone response to growth hormone-releasing hormone alone or combined with pyridostigmine in type 1 diabetic patients

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Abstract

In man the GH response to GHRH is variable within and between subjects. Pyridostigmine (PD), an acetylcholinesterase inhibitor, has been shown to reduce the variability of the GH response to GHRH in normal subjects. The aim of this study was to assess the existence of either inter- or intraindividual variability in the GH response to GHRH in type 1 diabetic patients. Moreover, we investigated the effect of PD on such variability in the same patients. Seven (4 females-3 males) nonobese type 1 diabetic patients underwent two experiments performed in consecutive days according to a single-blind protocol: 1) 120 mg oral PD 60 min before iv injection of human (h) GHRH-(1-29) NH2, 100 μg in 2 ml of sterile water; 2) oral placebo 60 min before iv injection of 100 μg hGHRH. The two experiments were then repeated, following the same procedure, one and two weeks after the start of the study. The GH peaks after GHRH were variable within different subjects but also in the same subject on different occasions. However, the mean GH peak levels after GHRH in the three tests were not significantly different (14.2±3.5, 15.3±3, 16.5±6.4 μg/L, respectively), the coefficient of variation for each test was 65%, 51.8%, 102.4%, respectively (mean 73.1±15.1%). The GH response to GHRH was always significantly enhanced by PD administration: the mean GH peak levels in the three tests were 31.9±7.1, 44.8±10.4, 49.9±13.1 μg/L, respectively, without significant differences between tests. After PD+GHRH the interindividual variability in the GH response was still present but significantly lower than after GHRH alone. The coefficient of variation for each test was 58.7%, 61.3%, 69.3%, respectively (mean 63.1±3.2%). It can be hypothesized that PD may reduce the interindividual variability of the GH response to GHRH in the diabetic population by decreasing somatostatin tone only in diabetic patients with normal-high hypothalamic somatostatin.

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Authors and Affiliations

  1. Cattedra di Clinica Medica, Università di Brescia, Brescia, Italy

    Andrea Giustina, C. Bodini, S. Bossoni & U. Valentini

  2. Department of Health Sciences, University of Wisconsin, Milwaukee, USA

    W. B. Wehrenberg

Authors
  1. Andrea Giustina
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  2. C. Bodini
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  3. S. Bossoni
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  4. U. Valentini
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  5. W. B. Wehrenberg
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Giustina, A., Bodini, C., Bossoni, S. et al. Variability in the growth hormone response to growth hormone-releasing hormone alone or combined with pyridostigmine in type 1 diabetic patients. J Endocrinol Invest 16, 585–590 (1993). https://doi.org/10.1007/BF03347676

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  • DOI: https://doi.org/10.1007/BF03347676

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