Lippe B M, Van Herle A J, LaFranchi S H, Uller R P, Lavin N, Kaplan S A
J Clin Endocrinol Metab. 1975 Apr;40(4):612-8. doi: 10.1210/jcem-40-4-612.
Six children with human growth hormone (hGH) deficiency became hypothyroid during the course of their therapy with hGH. This was accompanied by a decreasing growth rate, clinical symptoms of hypothyroidism and decreased serum T4 concentrations. Three of the 6 patients returned to the euthyroid state, both clinically and biochemically, with cessation of hGH therapy, and reinstitution of hGH precipitated hypothyroidism again in 2 of the three. The patients who remained hypothyroid have evidence of multiple pituitary trophic hormone deficiencies while those who reverted to euthyroidism appear to have isolated hGH deficiency. Evaluation of thyroid function while on hGH showed low T4, free T4 and T3 concentrations. The serum thyrotropin (TSH) response to thyrotropin-releasing hormone (TRH) was absent or markedly blunted in 4 of 6 patients while receiving long-term hGH therapy but was normal or exaggerated in all patients when tested before or after only 5 days of hGH therapy. These data indicate that exogenous hGH results in an inhibition of the TSH response to TRH. The mechanism of this inhibition is unclear, but we postulate that it may be mediated by somatostatin secretion in response to pulse doses of hGH.
6名生长激素（hGH）缺乏的儿童在接受hGH治疗过程中出现甲状腺功能减退。这伴随着生长速率下降、甲状腺功能减退的临床症状以及血清T4浓度降低。6名患者中有3名在停止hGH治疗后，临床和生化指标均恢复到甲状腺功能正常状态，而在这3名患者中的2名再次使用hGH后又引发了甲状腺功能减退。仍处于甲状腺功能减退状态的患者有多种垂体促激素缺乏的证据，而恢复到甲状腺功能正常状态的患者似乎仅有hGH缺乏。在使用hGH期间对甲状腺功能的评估显示T4、游离T4和T3浓度降低。在接受长期hGH治疗的6名患者中，有4名患者对促甲状腺激素释放激素（TRH）的血清促甲状腺激素（TSH）反应缺失或明显减弱，但在仅接受5天hGH治疗之前或之后进行检测时，所有患者的反应均正常或增强。这些数据表明外源性hGH会导致TSH对TRH的反应受到抑制。这种抑制的机制尚不清楚，但我们推测可能是由于对脉冲剂量hGH的反应而分泌生长抑素介导的。
