Journal of the Korean Pediatric Society 1993;36(3):312-319.
Published online March 15, 1993.
The Variability of Growth Hormone(GH) Response to Growth Hormone-Releasing Hormone(GHRH) according to the intrinsic Growth Hormone Secretory Rhythm in Children with Normal Growth Hormone Reserve
Sei Won Yang, Hyung Ro Moon
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
성장호르몬의 기저분비 양상에 따른 성장호르몬 유리호르몬(Growth Hormone Releasing Hormone, GHRH)에 대한 성장호르몬 반응의 다양성에 관한 연구
양세원, 문형로
서울대학교 의과대학 소아과학교실
Abstract
The diagnostic value of GHRH in assenssing GH secretion in biochemical GH suficient short children was examined. GHRH(1㎍/kg i.v bolus) was given to three groups (upslope, trough, downslope) arbitrarily classified according to the basal pulsatile GH secretory pattern before GHRH administration. Cmax following GHRH administration were variable and overlapping. Two children in downslope group, three children in though group, and one child in upslope group showed subnormal GH responses to GHRH administration despite of normal GH response to more than two classical GH provocative tests(Fig. 1). The time of maximal GH response after GHRH administration (Tmax) in upslope group was significantly faster than those in other two groups(Fig. 2). There was a highly significant correlation between AUC and Cmax(p<0.001) after GHRH administration(Fig. 3) which suggests that AUC or Cmax can be used for the parameters of GH response to GHRH each other. The AUC and Cmax after GHRH administration between three groups were significantly different (2764±579.1ng/ml,min, 52.6±ng/ml, respectively in upslope group ; 1645±383.9ng/ml,min, 37.7±9.4ng/ml, respectively in downslope group ; 1098±150.2ng/ml,min, 26.3±4.5ng/ml, respectively in trough group)(p<0.005)(Fig. 4, Table 1). In conclusion, GH responses to GHRH administration could be variable according to the basal GH secretory rhythm, Therefore, we should be cautious in interpreting the GH response to GHRH to evaluate the GH secretory capacity because subnormal GH response to GHRH administration could be observed even if normal GH response to classical GH provocative tests. In addition, the classification of these arbitary three groups (upslope, trough, and downslope) is remained to be defined so as to promote the diagnostic value of GHRH in GH deficiency.
Key Words: Intrinsic GH secretory rhythm


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