title: TRH test in patients with diabetes mellitus type 1 and/or autoimmune thyroiditis. Changes in the pituitary-thyroid axis, reverse T3, prolactin and growth hormone levels.
abstract: The response of the pituitary- thyroid axis, reverse triiodothyronine (rT3), prolactin, and growth hormone (GH) levels following TRH stimulus (Relefact TRH 200 microg 2 amp. i.v.) was examined in patients with autoimmune diabetes type 1 (DM1, n=30), with autoimmune thyroiditis (AT, n=25), and with concurrent DM1 and AT (n=22) to evaluate the influence of DM1 and AT of autoimmune pathogenesis on the above-mentioned hormonal parameters. Statistical analysis (ANOVA) showed that: a) the response of TSH did not differ from control groups (C); b) free triiodothyronine (fT3), free thyroxine (fT4) and their ratio in DM1, DM1+AT and C rose in 120 and 180 min, while a similar increase was not seen in AT (p<0.000001); c) rT3 was not present in any group, with rT3 levels higher in AT (p<0.00002) and lower in DM1 (p<0.02); d) the response of GH had a paradoxical character in some patients in all groups, most often in DM1 (52 %, DM1 vs C, p <0.01). The characteristic response difference was not in the peak GH level, but the delayed return to basal levels in DM1 (p<0.0001) and an abrupt one in AT (p<0.0001). The major findings in DM1 were the differences in GH response, while significant impairment of pituitary-thyroid axis and PRL response to TRH was absent. AT was associated with impairment of TRH stimulated fT3, fT4, fT3/fT4 response and changes in rT3 levels, in spite of preserved TRH-stimulated TSH secretion. GH response in AT patients was also altered.
authors.affiliation: Institute of Endocrinology, Prague, Czech Republic.
authors.forename: E
authors.initials: E
authors.lastname: Orlická
authors.forename: K
authors.initials: K
authors.lastname: Vondra
authors.forename: M
authors.initials: M
authors.lastname: Hill
authors.forename: J
authors.initials: J
authors.lastname: Skibová
authors.forename: I
authors.initials: I
authors.lastname: Sterzl
authors.forename: V
authors.initials: V
authors.lastname: Zamrazil
mesh_terms: D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis* / Q000378:metabolism*; D005260:Female; D006728:Hormones / Q000097:blood*; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D010902:Pituitary Gland / Q000378:metabolism; D011388:Prolactin / Q000097:blood; D013961:Thyroid Gland / Q000378:metabolism; D013967:Thyroiditis, Autoimmune / Q000175:diagnosis* / Q000378:metabolism*; D013973:Thyrotropin-Releasing Hormone; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood; D014285:Triiodothyronine, Reverse / Q000097:blood
chemical_list: D006728:Hormones; D014284:Triiodothyronine; D019382:Human Growth Hormone; D014285:Triiodothyronine, Reverse; D013973:Thyrotropin-Releasing Hormone; D011388:Prolactin; D013974:Thyroxine