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Negative correlation between plasma GHRH values and growth velocity in short prepubertal children
D Evain-Brion1, D Porquet, A Fjellestad-Paulsen
1Service d'Endocrinologie Pédiatrique, Hôpital Robert Debré, Paris, France.
Insights
Short children with suspected hypothalamic growth hormone dysregulation may have elevated growth hormone-releasing hormone (GHRH). This suggests increased somatostatin inhibition may impair growth hormone secretion in these cases.
Area of Science:
- Pediatric Endocrinology
- Neuroendocrinology
- Growth Disorders
Background:
- Impaired growth hormone secretion in short children is often linked to hypothalamic regulatory issues.
- Understanding neurohypothalamic dysfunction is crucial for diagnosing and treating growth deficiencies.
Purpose of the Study:
- To investigate basal and peak plasma growth hormone-releasing hormone (GHRH) levels in short children.
- To explore the relationship between GHRH levels, growth hormone (GH) response, and growth velocity in children with suspected hypothalamic GH dysregulation.
Main Methods:
- Measured basal and peak plasma GHRH levels in 43 prepubertal children.
- Stimulated GH release using L-dopa.
- Compared GHRH levels between children with suspected hypothalamic GH dysregulation and those with normal short stature.
- Correlated GHRH levels with peak GH response and growth velocity.
Main Results:
- Children suspected of hypothalamic GH dysregulation had significantly higher GHRH levels compared to normal short stature children.
- Elevated GHRH levels were not correlated with peak GH response after L-dopa stimulation.
- Higher GHRH levels were negatively correlated with growth velocity.
Conclusions:
- A predominant inhibitor of GH secretion, potentially increased somatostatin tone, may be present in many children with partial GH deficiency and suspected hypothalamic dysregulation.
- These findings suggest a specific mechanism contributing to growth failure in this pediatric population.
- Further research into somatostatin's role in pediatric short stature is warranted.
Abstract:
Numerous data suggest that impaired growth hormone secretion in short children is usually related to abnormal regulation of the hormone at the hypothalamic level. In order to improve our understanding of neurohypothalamic dysfunction in short children, we measured basal and peak (after L-dopa stimulation) plasma growth hormone-releasing hormone levels in 43 prepubertal children. Among them, in 23 children suspected of having hypothalamic growth hormone dysregulation, growth hormone-releasing hormone values were significantly higher than those observed in normal short stature children (n = 20), no longer correlated with peak growth hormone following L-dopa, and negatively correlated with growth velocity. This suggests that a predominant inhibitor of growth hormone secretion, such as an increase in somatostatin tone, might be prevalent in a large number of children with partial growth hormone deficiency and suspected hypothalamic growth hormone dysregulation.