Endocrine mediators of metabolism associated with injury and sepsis

We have studied the endocrine characteristics of 13 seriously ill patients with the use of a provocative intravenous glucose bolus. Notable in this stressed patient population was that no major interpatient differences in response to glucose were found for insulin, glucagon, cortisol, or epinephrine. However, following glucose challenge half of this group (7/13) exhibited a prominent "paradoxical" mean human growth hormone (hGH) elevation (26.4 +/- 9.3 microU/ml) whereas the others (6/13) exhibited only a minor increase (7.8 +/- 2.9 microU/ml). In addition, norepinephrine levels were significantly higher in the latter group suggesting that the adrenergic nervous system plays a major role in regulating hGH in stress.