Valcavi R, Zini M, Volta C, Ghizzoni L, Azzarito C, Bernasconi S, Portioli I
2a Divisione di Medicina Interna, Arcispedale S. Maria Nuova, Reggio Emilia, Italy.
J Clin Endocrinol Metab. 1994 Oct;79(4):1152-7. doi: 10.1210/jcem.79.4.7962288.
It has been suggested that hypothalamic regulation of GH secretion in children may differ from that in adults. On the other hand, there is evidence that oral glucose administration affects GH secretion through hypothalamic mechanisms. Therefore, we investigated spontaneous and GHRH-stimulated (1 microgram/kg BW) GH responses after oral glucose administration (children, 1.75 g/kg BW; adults, 75 g) in peripubertal normal children (13 girls and 13 boys, aged 11.7 +/- 0.4 yr; range, 8-13) and healthy adults (12 males and 14 females, aged 25.7 +/- 1.2 yr; range, 18-39). Three studies were carried out. In study 1, serum GH levels in 8 children were suppressed (< 1 microgram/L) for 135 min after oral glucose administration. Afterward, there was a rise in serum GH levels. In 8 adults, the suppressive effect of glucose persisted throughout the 210-min study period, and no GH rebound appeared. In study 2, the GH responses to iv GHRH boli in 10 adults and 10 children were, respectively, inhibited, unchanged, or augmented by an oral glucose load administered 30, 60, or 120 min before GHRH challenge. In study 3, oral glucose administration to 8 adults greatly enhanced the GH response to GHRH given 180 min after the glucose, whereas in 8 children, the GH response to GHRH was unchanged. In conclusion, glucose affects basal and GHRH-stimulated GH release in a similar manner in adults and children, indicating that neuroregulatory influences of glucose on the GH axis may not differ in the two age groups. In children, however, the duration of both the initial inhibitory and subsequent stimulatory effects of glucose administration on GH secretion is shorter.
有人提出,儿童下丘脑对生长激素(GH)分泌的调节可能与成人不同。另一方面,有证据表明口服葡萄糖通过下丘脑机制影响GH分泌。因此,我们研究了青春前期正常儿童(13名女孩和13名男孩,年龄11.7±0.4岁;范围8 - 13岁)和健康成人(12名男性和14名女性,年龄25.7±1.2岁;范围18 - 39岁)口服葡萄糖(儿童,1.75 g/kg体重;成人,75 g)后自发性和生长激素释放激素(GHRH)刺激(1微克/千克体重)的GH反应。进行了三项研究。在研究1中,8名儿童口服葡萄糖后血清GH水平被抑制(<1微克/升)达135分钟。之后,血清GH水平上升。在8名成人中,葡萄糖的抑制作用在整个210分钟的研究期间持续存在,且未出现GH反跳。在研究2中,在GHRH激发前30、60或120分钟给予口服葡萄糖负荷,分别抑制、未改变或增强了10名成人和10名儿童对静脉注射GHRH脉冲的GH反应。在研究3中,8名成人口服葡萄糖后极大地增强了在葡萄糖给药180分钟后给予的GHRH的GH反应,而在8名儿童中,对GHRH的GH反应未改变。总之,葡萄糖以相似的方式影响成人和儿童的基础及GHRH刺激的GH释放,表明葡萄糖对GH轴的神经调节影响在两个年龄组中可能没有差异。然而,在儿童中,葡萄糖给药对GH分泌的初始抑制和随后刺激作用的持续时间较短。