Kimber J, Sivenandan M, Watson L, Mathias C J
Neurovascular Medicine Unit, Division of Neuroscience and Psychological Medicine, Imperial College School of Medicine at St Mary's Hospital, London, UK.
Growth Horm IGF Res. 2001 Apr;11(2):128-35. doi: 10.1054/ghir.2001.0199.
The alpha(2)-adrenoceptor agonist clonidine stimulates growth hormone (GH) release in both animals and humans. It has been used to test for GH deficiency in children, to assess central alpha(2)-adrenoceptor function in adults and to determine the pathophysiological basis and to confirm diagnosis in neurological diseases with autonomic failure. The dose and mode of administration, however, may be important, as in some studies in adults oral clonidine has minimal effects on GH. We report our experience following intravenous (i.v.) clonidine (2 microg/kg) in 98 normal adults on the neuroendocrine (GH, insulin, glucose and catecholamine) and cardiovascular (blood pressure) responses. In males between 25 and 89 years and females between 25 and 64 years there was a significant rise in GH secretion (P < 0.05) after clonidine. Males showed an age-sensitive secretory pattern, with the greatest response between 25 and 35 years (P < 0.02). Younger males (< 45 years) had significantly higher peak GH levels post-clonidine than younger females < 45 years (P < 0.03). No sex-related change was observed in older subjects (< 45 years). Clonidine caused a significant fall in plasma noradrenalin and adrenalin in all age-sex groups (P< 0.001). There were no significant changes in glucose or insulin. There were no effects of age on the fall in blood pressure induced by clonidine. In conclusion, i.v. clonidine stimulated GH in all age groups and there was a marked sexually dimorphic pattern in adults < 45 years. The results overall suggest that i.v. clonidine-GH testing provides a reliable method for investigation of central alpha(2)-adrenergic function in adult humans.
α(2)-肾上腺素能受体激动剂可乐定可刺激动物和人类释放生长激素(GH)。它已被用于检测儿童的GH缺乏,评估成人的中枢α(2)-肾上腺素能受体功能,确定神经疾病伴自主神经功能衰竭的病理生理基础并确诊。然而,给药剂量和方式可能很重要,因为在一些针对成人的研究中,口服可乐定对GH的影响极小。我们报告了98名正常成年人静脉注射(i.v.)可乐定(2微克/千克)后,其神经内分泌(GH、胰岛素、葡萄糖和儿茶酚胺)和心血管(血压)反应的相关经验。在年龄介于25至89岁的男性和25至64岁的女性中,可乐定给药后GH分泌显著增加(P < 0.05)。男性呈现出年龄敏感的分泌模式,在25至35岁之间反应最为强烈(P < 0.02)。年龄小于45岁的年轻男性可乐定给药后的GH峰值水平显著高于年龄小于45岁的年轻女性(P < 0.03)。在年龄较大的受试者(> 45岁)中未观察到与性别相关的变化。可乐定导致所有年龄-性别组的血浆去甲肾上腺素和肾上腺素显著下降(P< 0.001)。葡萄糖或胰岛素无显著变化。年龄对可乐定引起的血压下降没有影响。总之,静脉注射可乐定可刺激所有年龄组的GH分泌,且在年龄小于45岁的成年人中存在明显的性别差异模式。总体结果表明,静脉注射可乐定-GH检测为研究成年人类中枢α(2)-肾上腺素能功能提供了一种可靠的方法。