In order to study the pituitary reserve of various pituitary hormones in patients with throid disorders, plasma growth hormone (HGH), adrenocorticotropic hormone (ACTH), luteinizing hormone (LH) and plasma 11-hydroxycorticosteroids (11-OHCS) in response to insulin-induced hypoglycemia and HGH to arginine infusion were examined. Twenty patients with hyperthyroidism (including 6 patients with periodic paralysis) and 8 patients with primary hypothyroidism were subjected to the studies. In some of the cases, studies were repeated after treatments when their condition became euthyroid. Insulin tolerance test was performed by injecting 0.1 u/kg of regular insulin and arginine infusion test by infusing 0.5 g/kg of 1-arginine for 30 min. Plasma pituitary hormones were measured by coated charcoal radioimmunoassay and plasma 11-OHCS by fluorometric technique with De Moor's method.
1. Responses of plasma HGH to both insulin-induced hypoglycemia and arginine infusion were deficient in both hyperthyroid and hypothyroid groups, especially in the hypothyroid group. The average peak value of plasma HGH to insulin-induced hypoglycemia was 14.0 mμg/ml after insulin injection in the hyperthyroid group and 2.8 mμg/ml in the hypothyroid group compared with 27.3 mμg/ml in normal subjects. Blood sugar levels fell comparably to normal subjects in both groups. The average peak value of plasma HGH to arginine infusion was 6.0 mμg/ml in the hyperthyroid group and 1.3 mμg/ml in the hypothyroid group compared with 30.2 mμg/ml in normal subjects.
2. In order to assess the role of adrenergic mechanism in HGH secretion in hyperthyroidism, 6 patients with hyperthyroidism were also subjected to insulin tolerance test after administration of propranolol, a beta blocker, either 30 mg/day orally for 2 weeks or by a single intravenous injection of 6 mg. But the responses of plasma HGH were not significantly different from those values which were obtained before administration.
3. The responses of plasma ACTH to insulin-induced hypoglycemia were diminished in both groups. The average peak value of ACTH to insulin was 142 μμg/ml in the hyperthyroid group and 91 μμg/ml in the hypothyroid group compared with 181 μμg/ml in normal subjects.
4. The responses of plasma LH to insulin were also impoverished in both groups. The average peak value of plasma LH after insulin was 39 μg/dl in the hyperthyroid group and 26 μg/dl in the hypothyroid group compared with 61 μg/dl in normal subjects.
5. The increments of plasma 11-OHCS in response to insulin-induced hypoglycemia were 9 μg/dl in the hyperthyroid group and 10μg /dl in the hypothyroid group compared with 15 μg/dl in normal subjects.
6. The disappearance rate of
131I-HGH from the plasma was measured in 2 patients with hyperthyroidism and a patient with hypothyroidism. Following a single intravenous injection of
131I-HGH using 0.1 μg (200 mc/mg), the disappearance curve in plasma plotted semilogarithmically against time indicated that the system was composed at least of 2 exponentials, the average half-life for the 2nd component was 68 min. in 2 patients with hyperthyroidism and 101 min. in a case of hypothyroidism against 59 min. in 2 normal subjects.
7. After treatment, the responses of plasma HGH, ACTH, LH and 11-OHCS almost returned to normal, though the recovery was better and sooner in patients with hyperthyroidism. For example, the average peak value of plasma HGH to insulin-induced hypoglycemia rose up to 34.2 mμg/ml in 6 patients treated for hyperthyroidism and 13.3 mμg/ml in 3 patients treated for hypothyroidism.
8. From the above results, it was concluded that the pituitary reserve of HGH, ACTH and LH was decreased in patients with thyroid disorders. As causative factors for diminished secretion of HGH which showed the most marked diminution among pituitary hormones examined,
View full abstract