title: Tall stature without growth hormone: four male patients with aromatase deficiency.
abstract: BACKGROUND
  From preliminary observations, GH-IGF-I seems to be compromised in men with aromatase deficiency. The GH deficiency (GHD) coexists paradoxically with tall stature, raising the question whether or not a true GHD is part of this rare syndrome.
  
  
  OBJECTIVE
  To evaluate the GH secretion in aromatase-deficient men, their GH response to the GHRH plus arginine (GHRH-ARG) test was compared with that of normal subjects. The effect of estrogen replacement treatment on the GH-IGF-I axis in aromatase-deficient men was evaluated before and during therapy.
  
  
  METHODS
  A case-control study was conducted.
  
  
  METHODS
  Four adult men with aromatase deficiency were compared with 12 normal subjects.
  
  
  METHODS
  We measured the GH response to GHRH-ARG in aromatase-deficient men (at baseline and during estrogen treatment) and in normal subjects. Basal serum IGF-I was measured in both patients and controls.
  
  
  RESULTS
  The response of GH to GHRH-ARG was severely impaired in men with aromatase deficiency and resulted in significantly lower (P < 0.001) levels than in normal subjects. Although normal, serum IGF-I levels were also significantly lower (P < 0.001) than in normal subjects. Both GH peak and IGF-I concentrations were not modified by estrogen therapy in men with aromatase deficiency.
  
  
  CONCLUSIONS
  In aromatase-deficient men, GH response to potent provocative stimuli is impaired and is not restored by exogenous estrogens. Furthermore, a tall stature may be reached, notwithstanding the coexistence of GHD, if a prolonged time for growth is available due to a delay in bone maturation, and other growth factors different from GH (mainly insulin) promote growth.
authors.affiliation: Integrated Department of Medicine, Endocrinology, Metabolism, and Geriatrics, Chair of Endocrinology, University of Modena and Reggio Emilia, Via Giardini 1355, 41100 Modena, Italy. cesare.carani@unimore.it.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Rochira
authors.forename: Lucia
authors.initials: L
authors.lastname: Zirilli
authors.forename: Laura
authors.initials: L
authors.lastname: Maffei
authors.forename: Valeria
authors.initials: V
authors.lastname: Premrou
authors.forename: Claudio
authors.initials: C
authors.lastname: Aranda
authors.forename: Matteo
authors.initials: M
authors.lastname: Baldi
authors.forename: Ezio
authors.initials: E
authors.lastname: Ghigo
authors.forename: Gianluca
authors.initials: G
authors.lastname: Aimaretti
authors.forename: Cesare
authors.initials: C
authors.lastname: Carani
authors.forename: Fabio
authors.initials: F
authors.lastname: Lanfranco
mesh_terms: D000328:Adult; D001120:Arginine; D001141:Aromatase / Q000172:deficiency* / Q000235:genetics; D001786:Blood Glucose / Q000378:metabolism; D001827:Body Height / Q000235:genetics / Q000502:physiology*; D015992:Body Mass Index; D001846:Bone Development / Q000235:genetics / Q000502:physiology; D016022:Case-Control Studies; D004958:Estradiol / Q000097:blood; D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000494:pharmacology; D006132:Growth Plate / Q000187:drug effects / Q000254:growth & development; D019382:Human Growth Hormone / Q000378:metabolism*; D006801:Humans; D007328:Insulin / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D011388:Prolactin / Q000097:blood; D011994:Recombinant Proteins; D013739:Testosterone / Q000172:deficiency
chemical_list: D001786:Blood Glucose; D004967:Estrogens; D007328:Insulin; D011994:Recombinant Proteins; D019382:Human Growth Hormone; D013739:Testosterone; D004958:Estradiol; D007334:Insulin-Like Growth Factor I; D011388:Prolactin; D001120:Arginine; D001141:Aromatase