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Growth hormone secretion in protein energy malnutrition
Insights
Protein energy malnutrition in infants can impair growth hormone (GH) secretion. Studies show high fasting GH levels and altered responses to stimulation tests, suggesting hypothalamopituitary axis dysfunction.
Area of Science:
- Pediatric Endocrinology
- Nutritional Science
- Endocrinology
Background:
- Protein energy malnutrition (PEM) is a significant health concern in infants.
- Growth hormone (GH) plays a crucial role in infant growth and development.
- The hypothalamopituitary axis regulates GH secretion.
Purpose of the Study:
- To investigate plasma human growth hormone (hGH) levels in infants with PEM.
- To assess the secretory function of the hypothalamopituitary axis in response to provocative stimuli in malnourished infants.
Main Methods:
- Plasma hGH levels were measured in 15 infants diagnosed with protein energy malnutrition.
- Stimulation tests included insulin-induced hypoglycemia, arginine, and L-Dopa provocation.
- An intravenous glucose tolerance test was also performed.
Main Results:
- Elevated fasting hGH levels were observed in 85.7% of the infants.
- Adequate hGH response to stimulation was limited: 42.8% for insulin, 52.5% for arginine, and 30.8% for L-Dopa.
- All infants receiving all three tests showed a response to at least one stimulus; exaggerated or delayed responses were noted.
Conclusions:
- Marasmic protein energy malnutrition may induce functional defects in the hypothalamopituitary axis's hGH secretory capacity.
- Impaired hGH response to provocative stimuli suggests a potential disruption in the neuroendocrine regulation of GH secretion in malnourished infants.
Abstract:
Plasma hGH levels were assessed in 15 infants with protein energy malnutrition following insulin induced hypoglycemia, arginine and L-Dopa provocation tests and intravenous glucose tolerance test. Fasting hGH levels were high in 85.7% of the cases. An adequate hGH response to stimulation was obtained in only 42.8% of the cases with insulin induced hypoglycemia; in 52.5% with arginine; in 30.8% with L-Dopa. Response to at least one type of provocation was obtained in all 5 cases to which all three tests were applied. Exaggerated or delayed response to provocative stimuli was also encountered in a number of the cases. Intravenous glucose tolerance test did not lead to suppression in hGH secretion or to increase in insulin secretion in these subjects. The results indicate that marasmic protein energy malnutrition may lead to defects in the hGH secretory function of the hypothalamopituitary axis.