title: Effect of corticoid therapy on growth hormone secretion.
abstract: Exogenous corticoids are known to be potent inhibitors of linear growth in children. We investigated the mechanisms underlying growth failure by evaluating growth hormone (GH) release during short-term high-dose prednisone treatment (40 mg/m2/day given orally in 3 divided doses) and 7 days after steroid withdrawal in 7 prepubertal children (4 males, 3 females, age range 3-12 years), affected by acute lymphoblastic leukemia. Patients also received weekly administrations of vincristine (1.5 mg/m2 i.v.), daunomycin (20 mg/m2 i.v.) and L-asparaginase (6,000 IU/m2 i.m.). Corticoid therapy suppressed GH secretion during deep sleep as well as in response to arginine, insulin and GH-releasing hormone (GHRH) administration. A significant recovery of GH responsiveness after drug discontinuation was observed during deep sleep (14.03 +/- 3.47 vs. 1.49 +/- 0.43 ng/ml, p less than 0.025) as well as in response to arginine (13.63 +/- 2.73 vs. 4.95 +/- 1.54 ng/ml, p less than 0.025) and GHRH (32.62 +/- 4.59 vs. 7.27 +/- 3.52 ng/ml, p less than 0.005) but not to insulin (7.12 +/- 0.88 vs. 4.47 +/- 0.96 ng/ml, p = NS). Insulin-like growth factor 1 levels during deep sleep (0.61 +/- 0.13 IU/ml/min) were found to be low in the course of steroid therapy and did not increase after drug withdrawal (0.41 +/- 0.07 IU/ml/min). Our preliminary data suggest that recovery of adrenergic response to insulin does not immediately follow corticosteroid discontinuation.
authors.affiliation: Pediatric Clinic, University of Pavia, IRCCS Policlinico San Matteo, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bozzola
authors.forename: F
authors.initials: F
authors.lastname: Locatelli
authors.forename: D
authors.initials: D
authors.lastname: Gambarana
authors.forename: A
authors.initials: A
authors.lastname: Moretta
authors.forename: A
authors.initials: A
authors.lastname: Valtorta
authors.forename: G
authors.initials: G
authors.lastname: Giorgiani
authors.forename: M
authors.initials: M
authors.lastname: Cisternino
authors.forename: F
authors.initials: F
authors.lastname: Severi
mesh_terms: D001120:Arginine / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006128:Growth / Q000187:drug effects; D013006:Growth Hormone / Q000378:metabolism*; D013007:Growth Hormone-Releasing Hormone / Q000494:pharmacology; D006801:Humans; D007328:Insulin / Q000494:pharmacology; D007334:Insulin-Like Growth Factor I / Q000096:biosynthesis; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000188:drug therapy; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D007328:Insulin; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D013007:Growth Hormone-Releasing Hormone; D001120:Arginine; D011241:Prednisone