title: Pituitary release of growth hormone and prolactin in the primary fibromyalgia syndrome.
abstract: OBJECTIVE
  Previously, we demonstrated hyperreactive adrenocorticotropic hormone (ACTH) release in patients with primary fibromyalgia syndrome (primary FMS). We investigated the pituitary release of growth hormone (GH) and prolactin (PRL) in search of further disturbances in neuroendocrine reactivity possibly associated with the pathophysiology of primary FMS.
  
  
  METHODS
  Ten female patients with primary FMS fulfilling the 1981 Yunus criteria and 10 matched, healthy and sedentary controls were subjected to an insulin induced hypoglycemia test; samples for measurement of glucose, GH and PRL were taken at intervals.
  
  
  RESULTS
  Compared to the controls, the patients with primary FMS displayed significantly lower basal GH levels, whereas their basal PRL levels were slightly, though significantly, higher (respectively p = 0.021 and p = 0.041). Following hypoglycemia, there was a marked, statistically highly significant (p = 0.001), hyperreactivity of the GH response in patients with primary FMS. The PRL response showed wide interindividual variation and did not differ between patients and controls.
  
  
  CONCLUSIONS
  Our findings indicate that fibromyalgia, along with ACTH hyperreactivity, also exhibits a distinct disturbance in the GH-somatomedin C axis. With regard to PRL, the variation in individual responses limits conclusions. The hyperreactive response patterns of GH and ACTH previously suggest a common origin, which might be related to a subtle glucocorticoid deficiency.
authors.affiliation: Department of Rheumatology, Rijnstate Hospital, Arnhem, The Netherlands.
authors.forename: E N
authors.initials: EN
authors.lastname: Griep
authors.forename: J W
authors.initials: JW
authors.lastname: Boersma
authors.forename: E R
authors.initials: ER
authors.lastname: de Kloet
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D016022:Case-Control Studies; D005260:Female; D005356:Fibromyalgia / Q000097:blood / Q000378:metabolism*; D013006:Growth Hormone / Q000097:blood / Q000378:metabolism*; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced; D007275:Injections, Intravenous; D007328:Insulin / Q000008:administration & dosage; D008875:Middle Aged; D010902:Pituitary Gland / Q000378:metabolism*; D011388:Prolactin / Q000097:blood / Q000378:metabolism*; D013577:Syndrome
chemical_list: D001786:Blood Glucose; D007328:Insulin; D011388:Prolactin; D013006:Growth Hormone