| Abstrakt: |
Glucagon (G), an accepted provocative stimulus for hGH release, would have greater usefulness if shown to effect the release of other trophic hormones. hGH response to G was studied in 10 children, ages 6-14 yrs, with simultaneous evaluation of ACTH and F responses.Beginning at 0800 hrs, specimens were obtained at 30' Intervals for hGH, ACTH, and F, which were measured by RIA, and for blood glucose (autoanalyzer), between −30 and +180' after a img IM dose of G.hGH responses were normal in 8/10 patients (> 10 ng/ml). In these 8, two types of ACTH-F response were noted; in 5 patients with a fasting F(FO) of < 10 μg/dl, ACTH increased 4.5-fold (Δ ACTH 40-393 pg/ml), and F 5.6-fold (Δ F 15-27.3); the mean ACTH peak occurred at 150' and mean F peak at 180'. In two patients with an Fo> 10/ μg/dl, ACTH increased only two-fold (A ACTH 6 and 265 pg/ml), and F 1.5-fold (Δ 9.8 and 23.0 μg/dl). The ACTH and F peaks occurred as in the first group. One patient showed no change in F (range 19.5-23.0 μg/dl) and a 60% decrease in ACTH between 120' and 150'.Two of the ten children had hGH and TSH deficiency. One had an Foof < 0.5 μg/dl and a rise in F to only 7.2; his ACTH increased from 10 to 38.0 pg/ml. The second patient showed an increase in F from 10.5-23.5 μg/dl; her ACTH increased from 37-50 μg/ml.The pattern of the glucose response was similar in all groups, depicting the classic blphasic curve, with a hyperglycemic phase followed by a gradual decline in concentration. Nausea and Abdominal discomfort were present in only one patient.This study shows glucagon to be a reliable and safe provocative stimulus, not only for hGH release, but also for the assessment of the pituitary-adrenal axis. Studies, in progress, should help to elucidate its mechanism of action. |
