Growth hormone secretion in protein energy malnutrition.

Plasma hGH levels were assessed in 15 infants with protein energy malnutrition following insulin induced hypoglycemia, arginine and L-Dopa provocation tests and intravenous glucose tolerance test. Fasting hGH levels were high in 85.7% of the cases. An adequate hGH response to stimulation was obtained in only 42.8% of the cases with insulin induced hypoglycemia; in 52.5% with arginine; in 30.8% with L-Dopa. Response to at least one type of provocation was obtained in all 5 cases to which all three tests were applied. Exaggerated or delayed response to provocative stimuli was also encountered in a number of the cases. Intravenous glucose tolerance test did not lead to suppression in hGH secretion or to increase in insulin secretion in these subjects. The results indicate that marasmic protein energy malnutrition may lead to defects in the hGH secretory function of the hypothalamopituitary axis.