Ryan N D, Dahl R E, Birmaher B, Williamson D E, Iyengar S, Nelson B, Puig-Antich J, Perel J M
Department of Psychiatry, University of Pittsburgh, PA.
J Am Acad Child Adolesc Psychiatry. 1994 Jul-Aug;33(6):824-33. doi: 10.1097/00004583-199407000-00008.
Blunted stimulation of growth hormone (GH) secretion after pharmacological stimuli has been linked to depressive and anxiety disorders throughout the life span. This study sought to better characterize this dysregulation in prepubertal depression.
GH regulation was compared in 38 medically healthy prepubertal children with current major depressive disorder and 19 control children who were medically and psychiatrically healthy. The study evaluated GH stimulatory responses to three pharmacological challenge agents: (1) insulin-induced hypoglycemia, using 0.1 IU/kg intravenous regular insulin; (2) 1.3 micrograms/kg intravenous clonidine; and (3) 1.0 microgram/kg intravenous human growth hormone-releasing hormone (GHRH).
The results provide replication and extension of earlier findings. GH responses to insulin-induced hypoglycemia and to GHRH stimulation were blunted in depressed children compared to the normal controls. Clonidine stimulation results yielded a similar picture but did not reach statistical significance.
Overall these results further strengthen the evidence showing GH dysregulation in childhood depression. However, the blunted GH response seen with GHRH (which reflects pituitary hyporesponsivity) was in contrast to our original hypothesis and has implications regarding the site (or sites) of dysregulation.
药理学刺激后生长激素（GH）分泌减弱与全生命周期的抑郁和焦虑障碍有关。本研究旨在更好地描述青春期前抑郁症中这种调节异常的特征。
比较了38名患有当前重度抑郁症的医学健康的青春期前儿童和19名医学和精神健康的对照儿童的GH调节情况。该研究评估了GH对三种药理学激发剂的刺激反应：（1）胰岛素诱导的低血糖，使用0.1 IU/kg静脉注射正规胰岛素；（2）1.3微克/千克静脉注射可乐定；（3）1.0微克/千克静脉注射人生长激素释放激素（GHRH）。
结果重复并扩展了早期研究结果。与正常对照组相比，抑郁儿童对胰岛素诱导的低血糖和GHRH刺激的GH反应减弱。可乐定刺激结果呈现类似情况，但未达到统计学意义。
总体而言，这些结果进一步加强了表明儿童抑郁症中GH调节异常的证据。然而，GHRH刺激时出现的GH反应减弱（这反映了垂体反应性降低）与我们最初的假设相反，并且对调节异常的部位有影响。
