Martha P M, Gorman K M, Blizzard R M, Rogol A D, Veldhuis J D
Department of Pediatrics, University of Virginia Health Sciences Center, Charlottesville.
J Clin Endocrinol Metab. 1992 Feb;74(2):336-44. doi: 10.1210/jcem.74.2.1730812.
Mean plasma GH concentrations increase in normal boys during mid- to late-puberty. To investigate the nature of the pituitary secretory events and/or altered metabolic clearance responsible for these serum GH concentration changes, we performed multiple-parameter deconvolution analysis of 46 24-h serum GH concentration-time series obtained from normal boys at various stages of puberty and young adulthood. The subjects ranged in chronological age from 7-27 yr. The height and weight of each subject were between the 5th and 95th percentile for age. The calculated daily mass of GH secreted was greatest (P less than 0.001) in late pubertal boys (mean +/- SE, 1810 +/- 250 micrograms/24 h) and was triple the value in prepubertal boys (610 +/- 65 micrograms/24 h). When the values were normalized and expressed as mass of GH secreted per unit (m2) body surface area or per L distribution volume, GH secretion in late pubertal boys was still significantly greater than that in any other group (P less than 0.05). These values for late pubertal boys were nearly double the corresponding values for prepubertal boys (1160 +/- 160 vs. 600 +/- 58 micrograms GH/m2.24 h and 440 +/- 63 vs. 270 +/- 25 micrograms GH/L vol.24 h, respectively). When the effect of clearance mechanics on serum GH concentrations was removed mathematically, the primary change in predicted GH secretory burst parameters during pubertal development was an increase in GH mass released per burst resulting from an increase in the maximal rate of GH secretion attained within the bursts. These changes in the amplitude of GH release events were specific, in that they were largely independent of any accompanying alterations in duration or frequency of the GH secretory bursts or in serum GH half-life. Correlation analysis revealed that the 24-h GH secretion rate varied inversely with the subjects' body mass index SD score (r = -0.65; P less than 0.01), suggesting that differences in body mass, even within the normal range, contribute to the wide variability in daily GH secretion rates among normally growing children. The plasma insulin-like growth factor-I concentrations of all subjects correlated positively with the calculated 24-h GH secretion rate (r = 0.51; P less than 0.001). In summary, the primary neuroendocrine alteration responsible for the augmented serum GH concentrations characterizing mid- to late-puberty in boys is an increased mass of GH released per pituitary secretory episode resulting from an increased maximal rate of GH secretion within each burst.(ABSTRACT TRUNCATED AT 400 WORDS)
正常男孩在青春期中后期血浆生长激素(GH)平均浓度会升高。为了研究导致这些血清GH浓度变化的垂体分泌事件的性质和/或代谢清除率改变,我们对46个来自青春期不同阶段和青年期正常男孩的24小时血清GH浓度-时间序列进行了多参数反卷积分析。受试者的实际年龄在7至27岁之间。每个受试者的身高和体重处于年龄对应的第5至95百分位数之间。计算得出青春期后期男孩分泌的GH每日总量最大(P<0.001)(均值±标准误,1810±250微克/24小时),是青春期前男孩(610±65微克/24小时)的三倍。当将这些值标准化并表示为每单位(m2)体表面积或每升分布容积分泌的GH量时,青春期后期男孩的GH分泌仍显著高于其他任何组(P<0.05)。青春期后期男孩的这些值几乎是青春期前男孩相应值的两倍(分别为1160±160对600±58微克GH/m2·24小时和440±63对270±25微克GH/升容积·24小时)。当通过数学方法消除清除机制对血清GH浓度的影响时,青春期发育期间预测的GH分泌突发参数的主要变化是每次突发释放的GH量增加,这是由于突发内达到的GH分泌最大速率增加所致。GH释放事件幅度的这些变化是特异性的,因为它们在很大程度上独立于GH分泌突发的持续时间或频率或血清GH半衰期的任何伴随变化。相关性分析显示,24小时GH分泌率与受试者的体重指数标准差评分呈负相关(r = -0.65;P<0.01),这表明即使在正常范围内,体重差异也会导致正常生长儿童每日GH分泌率的广泛差异。所有受试者的血浆胰岛素样生长因子-I浓度与计算得出的24小时GH分泌率呈正相关(r = 0.51;P<0.001)。总之,导致男孩青春期中后期血清GH浓度升高的主要神经内分泌改变是每次垂体分泌事件释放的GH量增加,这是由于每次突发内GH分泌最大速率增加所致。(摘要截短至400字)