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The catecholamine response to hypoglycemia in children with isolated growth hormone deficiency syndromes and multiple

S A Chalew, A A Kowarski

    Pediatric Research
    |November 1, 1986
    PubMed

    Insights

    Short children with isolated growth hormone (GH) deficiency show normal catecholamine responses to hypoglycemia. Impaired epinephrine response is linked to multiple pituitary hormone deficiencies, not GH deficiency alone.

    Area of Science:

    • Pediatric Endocrinology
    • Neuroendocrinology
    • Metabolic Disorders

    Background:

    • Assessing growth hormone (GH) deficiency in children involves evaluating hormonal responses to stimuli.
    • Catecholamine and cortisol responses to hypoglycemia are critical indicators of pituitary function.

    Purpose of the Study:

    • To investigate the catecholamine and cortisol response to insulin-induced hypoglycemia in short children with varying degrees of GH deficiency.
    • To determine if isolated GH deficiency impacts the neuroendocrine stress response.

    Main Methods:

    • Evaluated 46 short children using pharmacologic stimulation and integrated GH concentration tests.
    • Categorized patients into GH-normal (GHNORM), GH-deficient non-deficient by concentration (GHND), and GH-deficient (GHD) groups (Type 1: isolated, Type 2: multiple deficiencies).
    • Measured catecholamine (epinephrine, norepinephrine) and cortisol levels during insulin-induced hypoglycemia.

    Main Results:

    • No significant differences in epinephrine, norepinephrine, or cortisol responses were observed between GHNORM, GHND, and GHD Type 1 groups.
    • GHD Type 2 patients exhibited a significantly lower peak epinephrine response compared to other groups.
    • No correlation was found between blood glucose decrease and GH, catecholamine, or cortisol increases; however, epinephrine and cortisol responses were correlated.

    Conclusions:

    • Isolated GH deficiency does not impair the catecholamine response to hypoglycemia.
    • Impaired epinephrine response to hypoglycemia is associated specifically with multiple pituitary hormone deficiencies.
    • In children, the extent of hypoglycemia does not correlate with the magnitude of GH, catecholamine, or cortisol responses.

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