Rappaport R, Prevot C, Brauner R
INSERM U.30, Hôpital des Enfants-Malades, Paris, France.
J Clin Endocrinol Metab. 1987 Dec;65(6):1112-7. doi: 10.1210/jcem-65-6-1112.
This study was undertaken to investigate the role of GH secretion in the pubertal increase in plasma somatomedin-C (Sm-C) concentrations and its relation to growth in children with true precocious puberty (PP) and normal or deficient GH secretion. We studied 37 children (9 boys and 28 girls), divided into 3 groups according to their pubertal stages and their peak stimulated plasma GH concentration. Group I (n = 20) contained patients with PP and normal GH secretion. In group II (n = 8), PP was accompanied by GH deficiency. Group III (n = 9) patients were GH deficient and prepubertal. The mean plasma Sm-C (RIA) levels in groups I and II were 2.01 +/- 0.17 (+/- SEM) and 0.59 +/- 0.21 U/mL, respectively (P less than 0.001), and it was 0.09 +/- 0.01 U/mL in group III (P less than 0.001 compared to group II). The higher mean plasma Sm-C level in group II compared to that in group III could be related to a significantly higher GH response to arginine-insulin stimulation (P less than 0.02), although this value was in the hypopituitary range. The mean growth rate in group II (6.8 +/- 0.9 cm/yr) was also much higher than the rate in group III (1.9 +/- 0.5 cm/yr; P less than 0.001) and only slightly lower than that in group I (90 +/- 0.8 cm/yr; P less than 0.05). These data indicate that plasma Sm-C values are closely correlated with even small changes in GH secretion. The observed growth rates could, in general, be linked to plasma GH and Sm-C levels, as modulated by sex steroids, in these patients with precocious puberty.
本研究旨在探讨生长激素（GH）分泌在青春期血浆生长调节素C（Sm-C）浓度升高过程中的作用，及其与真性性早熟（PP）且生长激素分泌正常或缺乏的儿童生长之间的关系。我们研究了37名儿童（9名男孩和28名女孩），根据其青春期阶段和刺激后血浆GH峰值浓度分为3组。第一组（n = 20）为性早熟且生长激素分泌正常的患者。第二组（n = 8）中，性早熟伴有生长激素缺乏。第三组（n = 9）患者为生长激素缺乏且未进入青春期。第一组和第二组的血浆Sm-C（放射免疫分析）平均水平分别为2.01±0.17（±标准误）和0.59±0.21 U/mL（P<0.001），第三组为0.09±0.01 U/mL（与第二组相比P<0.001）。与第三组相比，第二组较高的血浆Sm-C平均水平可能与对精氨酸 - 胰岛素刺激的生长激素反应显著更高有关（P<0.02），尽管该值处于垂体功能减退范围内。第二组的平均生长速率（6.8±0.9 cm/年）也远高于第三组（1.9±0.5 cm/年；P<0.001），且仅略低于第一组（9.0±0.8 cm/年；P<0.05）。这些数据表明，血浆Sm-C值与生长激素分泌的微小变化密切相关。在这些性早熟患者中，观察到的生长速率总体上可能与血浆生长激素和Sm-C水平相关，受性类固醇调节。
