[An observation of the secretion of growth hormone and contraction of gall bladder after long-term use of growth-inhibition excitants].
We sought to examine the feasibility of intermittent dosing of octreotide in acromegalics to avoid the well-documented side effect of cholelithiasis. In fourteen acromegalic patients, we measured serum GH, five hour GH profile (mean GH, measured hourly 8:00 am to 12:00 pm) prior to the discontinuation of octreotide and weekly thereafter. In addition, gallbladder contractility was quantitated using the percent of relative gallbladder contractility (PRGC) obtained by ultrasound during a fat meal test. One week after withdrawal of octreotide, basal GH and five our GH profile (14.6 +/- 3.3 micrograms/L, 13.4 +/- 3.2 micrograms/L, respectively) were significantly less than (P < 0.01, P < 0.05), and represented 36% and 24% of their respective pretreatment values. At the end of two weeks, these parameters were 60% and 56% of their pretreatment levels. We also measured serum octreotide levels following withdrawal; the drug is completely eliminated from the serum within 3 day. In all of 6 patients who did not develop stones, PRGC normalized within one week. In 8 patients who developed stones, 3 of them had restoration of normal contractility in 2 weeks. Our results show that upon withdrawal of octreotide, gall bladder contractility normalizes while GH suppression persists for a longer period of time. Therefore, intermittent therapy may allow clearance of stagnated bile and hence decrease the incidence of cholelithiasis in acromegalic patients receiving long term octreotide therapy.
Zhu
X F
XF
Peking Union Medical College Hospital, Beijing.
Shi
Y F
YF
Gao
S M
SM
D000172:Acromegaly / Q000188:drug therapy / Q000503:physiopathology*; D000328:Adult; D002769:Cholelithiasis / Q000517:prevention & control; D005240:Feasibility Studies; D005260:Female; D005704:Gallbladder / Q000503:physiopathology*; D013006:Growth Hormone / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D009130:Muscle, Smooth; D015282:Octreotide / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies
D013006:Growth Hormone; D015282:Octreotide