Giustina A, Girelli A, Alberti D, Bossoni S, Buzi F, Doga M, Schettino M, Wehrenberg W B
Clinica Medica, University of Brescia, Italy.
Clin Endocrinol (Oxf). 1991 Dec;35(6):491-8. doi: 10.1111/j.1365-2265.1991.tb00933.x.
We aimed to investigate both nocturnal spontaneous and morning growth hormone (GH)-releasing hormone (GHRH)-induced GH secretion in children on daily glucocorticoid treatment after liver transplantation and to evaluate the effect of pyridostigmine (an acetylcholinesterase inhibitor thought to reduce hypothalamic somatostatin tone) on GH secretion in these patients.
We performed a randomized, single-blind, cross-over study.
We studied three male and three female juvenile patients, within a year of orthotopic liver transplantation and under immunosuppressive glucocorticoid therapy (mean dose +/- SEM, 5.92 +/- 0.63 mg/day) and five normal children (four males, one female).
Both nocturnal spontaneous and morning GHRH-induced GH secretion were evaluated after administration of placebo, 1 tablet p.o., or pyridostigmine, 2 mg/kg p.o.
Spontaneous GH. Placebo: in liver transplanted children nocturnal GH secretion (mean GH level 10.8 +/- 2.0 mU/l) was not significantly different with respect to normal children (mean GH level 12.8 +/- 1.2 mU/l); pyridostigmine: nocturnal GH secretion was significantly increased as compared to placebo in subjects with liver transplantation but not in normal children. GHRH test. Placebo: liver transplanted patients showed a blunted GH response to GHRH with respect to normal children; pyridostigmine: the GH responses to GHRH (P less than 0.05) increased as compared to placebo and did not differ significantly in the two groups.
Our data suggest a steroid-mediated increase in hypothalamic somatostatin tone in liver transplanted children.
我们旨在研究肝移植后每日接受糖皮质激素治疗的儿童夜间自发性及早晨生长激素释放激素（GHRH）诱导的生长激素（GH）分泌情况，并评估吡啶斯的明（一种被认为可降低下丘脑生长抑素水平的乙酰胆碱酯酶抑制剂）对这些患者GH分泌的影响。
我们进行了一项随机、单盲、交叉研究。
我们研究了3名男性和3名女性青少年患者，他们在原位肝移植后一年内，接受免疫抑制糖皮质激素治疗（平均剂量±标准误，5.92±0.63毫克/天），以及5名正常儿童（4名男性，1名女性）。
在给予安慰剂（口服1片）或吡啶斯的明（口服2毫克/千克）后，评估夜间自发性及早晨GHRH诱导的GH分泌情况。
自发性GH。安慰剂：肝移植儿童夜间GH分泌（平均GH水平10.8±2.0 mU/l）与正常儿童（平均GH水平12.8±1.2 mU/l）相比无显著差异；吡啶斯的明：与安慰剂相比，肝移植患者夜间GH分泌显著增加，但正常儿童无此变化。GHRH试验。安慰剂：肝移植患者对GHRH的GH反应相对于正常儿童减弱；吡啶斯的明：与安慰剂相比，对GHRH的GH反应（P<0.05）增加，且两组间无显著差异。
我们的数据表明，肝移植儿童下丘脑生长抑素水平受类固醇介导而升高。
