Saggese G, Cesaretti G, Giannessi N, Bracaloni C, Cinquanta L, Cioni C
Department of Pediatrics, University of Pisa, Italy.
J Clin Endocrinol Metab. 1992 Feb;74(2):272-8. doi: 10.1210/jcem.74.2.1346143.
A reduced GH secretion has often been shown in prepubertal children with delays in pubertal development. In order to study the mechanism underlying this finding, we evaluated peripheral circulating levels of GH, GHRH, and somatostatin (SRIH) before and after the onset of sexual development in a group of eight late maturing children (six boys, two girls), comparing the results with those obtained in two groups of five prepubertal and four pubertal short children with familial short stature. GH was measured by a two-site immunoradiometric assay. Both GHRH and SRIH were assayed by specific RIAs after an acetone-petrolether extraction from plasma. Our data showed a significant increase (P less than 0.001) in GH, GHRH, and SRIH levels (peak vs. basal values) in response to L-dopa administration in all groups. In pubertal children with delays in pubertal development GH and GHRH peak values (15.8 +/- 2.2 micrograms/L and 120 +/- 18 pg/mL, respectively) were significantly greater (P less than 0.001) than in the same subjects before puberty (8.2 +/- 0.9 micrograms/L and 79 +/- 9 pg/mL, respectively), whereas SRIH peak values did not significantly change (41 +/- 6 vs. 41 +/- 5 pg/mL; P = NS). Furthermore, prepubertal subjects with delays in pubertal development showed GH and GHRH peak values lower (P less than 0.001) than those of prepubertal subjects with FSS (13.3 +/- 1.8 micrograms/L and 120 +/- 13 pg/mL, respectively), whereas no statistical difference was present between the two groups of subjects after pubertal development (18.2 +/- 2.9 micrograms/L and 128 +/- 11 pg/mL, respectively). In conclusion, these findings support the assumption that in late maturing subjects during prepubertal period the decreased GH secretion may be ascribed to a reduced GHRH secretion, reversible with the onset of puberty, without change in circulating SRIH levels.
青春期发育延迟的青春期前儿童常常出现生长激素(GH)分泌减少的情况。为了研究这一现象背后的机制,我们评估了一组8名青春期发育较晚的儿童(6名男孩,2名女孩)在性发育开始前后外周循环中GH、生长激素释放激素(GHRH)和生长抑素(SRIH)的水平,并将结果与两组儿童进行比较,一组是5名青春期前身材矮小的儿童,另一组是4名患有家族性矮小症的青春期身材矮小儿童。GH通过双位点免疫放射分析进行测定。GHRH和SRIH均在血浆经丙酮 - 石油醚萃取后通过特定的放射免疫分析法进行测定。我们的数据显示,所有组在给予左旋多巴后,GH、GHRH和SRIH水平(峰值与基础值相比)均有显著升高(P < 0.001)。青春期发育延迟的青春期儿童,其GH和GHRH峰值(分别为15.8±2.2μg/L和120±18pg/mL)显著高于青春期前同一受试者(分别为8.2±0.9μg/L和79±9pg/mL)(P < 0.001),而SRIH峰值无显著变化(41±6与41±5pg/mL;P =无显著性差异)。此外,青春期发育延迟的青春期前受试者的GH和GHRH峰值低于患有家族性矮小症的青春期前受试者(分别为13.3±1.8μg/L和120±13pg/mL)(P < 0.001),而青春期发育后两组受试者之间无统计学差异(分别为18.2±2.9μg/L和128±11pg/mL)。总之,这些发现支持了这样一种假设,即在青春期前发育较晚的受试者中,GH分泌减少可能归因于GHRH分泌减少,随着青春期的开始这种情况是可逆的,而循环中的SRIH水平没有变化。