Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, 23 Kyungheedae-ro, Dongdaemoon-gu, Seoul 130-702, Republic of Korea.
Int J Endocrinol. 2013;2013:159858. doi: 10.1155/2013/159858. Epub 2013 Nov 21.
Objective. The aim of this study was to investigate how the paradoxical response of GH secretion to TRH changes according to tumor volumes. Methods. Patients with newly diagnosed acromegaly were classified as either TRH responders or nonresponders according to the results of a TRH stimulation test (TST), and their clinical characteristics were compared according to responsiveness to TRH and tumor volumes. Results. A total of 41 acromegalic patients who underwent the TST were included in this study. Between TRH responders and nonresponders, basal GH, IGF-I levels, peak GH levels, and tumor volume were not significantly different, but the between-group difference of GH levels remained near significant over the entire TST time. ΔGHmax-min during the TST were significantly different according to the responsiveness to TRH. Peak GH levels and ΔGHmax-min during the TST showed significantly positive correlations with tumor volume with higher levels in macroadenomas than in microadenomas. GH levels over the entire TST time also remained significantly higher in macroadenomas than in microadenomas. Conclusion. Our data demonstrated that the paradoxical response of GH secretion to TRH in GH-producing pituitary adenomas was not inversely correlated with tumor volumes.
目的。本研究旨在探讨 GH 分泌对 TRH 的矛盾反应如何根据肿瘤体积而变化。
方法。根据 TRH 刺激试验(TST)的结果,将新诊断为肢端肥大症的患者分为 TRH 反应者和非反应者,并根据对 TRH 的反应性和肿瘤体积比较其临床特征。
结果。本研究共纳入 41 例接受 TST 的肢端肥大症患者。TRH 反应者和非反应者之间的基础 GH、IGF-I 水平、GH 峰值水平和肿瘤体积无显著差异,但整个 TST 期间 GH 水平的组间差异仍接近显著。TST 期间的 ΔGHmax-min 根据 TRH 的反应性而显著不同。峰值 GH 水平和 TST 期间的 ΔGHmax-min 与肿瘤体积呈显著正相关,大腺瘤中的水平高于微腺瘤。整个 TST 时间的 GH 水平在大腺瘤中也显著高于微腺瘤。
结论。我们的数据表明,生长激素分泌对 TRH 的矛盾反应与肿瘤体积无关。