BACKGROUND: It has been already known that each trophic hormone in combined pituitary responsiveness according to gender and age brings about variable response, but in Korea, there has been no actual data. In this study, in order to assess the pituitary responsiveness, a combined pituitary stimulation test was performed in Korean subjects with the variation in CRH, GHRH, GnRH, and TRH according to their age and gender. Were these the variables that were changed according to age and gender? Clarify that. Also, it might be good to write out the abbreviations.) METHOD: Fourteen physically and mentally healthy male subjects and fourteen female subjects, also physically and mentally healthy, underwent the combined anterior pituitary stimulation test by CRH, GHRH, LHRH, and TRH. Each gender group was divided further into young(meanSE; male: 231, female: 221) and old (mean; male: 513, female: 522) groups. RESULTS: There were significant differences between the gender and age groups. The Peak GH level and maximal GH increment were significantly increased in young men compared to old men. The Peak ACTH level and maximal ACTH increment were significantly increased in old men as opposed to young men. The Peak PRL level, maximal PRL increment, Peak TSH level, and maximal TSH increment were significantly increased in old women compared to old men. The Peak FSH level was significantly increased in the two old groups compared to the young groups, which showedindependence in gender, and the maximal FSH increment was significantly increased in old men when compared with the young men. CONCLUSION: These results show that in order to for accurate interpretation of the response from the combined pituitary stimulation test, it is necessary to consider age and gender of the subjects. We suggest response values of the combined pituitary stimulation test in terms of age and gender in healthy Korean subjects.
Adrenocorticotropic Hormone ; Corticotropin-Releasing Hormone ; Female ; Gonadotropin-Releasing Hormone* ; Growth Hormone-Releasing Hormone ; Humans* ; Korea ; Male

No abstract available.
Arginine ; Growth Hormone* ; Growth Hormone-Releasing Hormone ; Somatostatin

PURPOSE: GnRH analogues(GnRHa) are used to treat central precocious puberty(CPP). However, in some patients, the GV decrease is so remarkable that it impairs predicted adult height(PAH); and there fore, the addition of growth hormone(GH) is suggested. We analysed the growth changes during two years and final adult height(FAH) in girls with idiopathic CPP treated with combined therapy, compared with those of girls treated with GnRHa alone. METHODS: For the analysis, we classified the patients, who was treated for longer than two years, into three groups depending on the initial PAH and combination of GH; PAH_L, treated with GnRHa and PAH less than midparental height(MPH) -5 cm. PAH_H, treated with GnRHa and PAH greater than MPH -5 cm. GnRHa+GH, combined GH treatment, regardless of PAH before treatment. We analysed the GV and PAH change during the first two years and FAH. RESULTS: In PAH_L, the PAH(SDS) at first year of therapy was significantly increased to 153.5+/-6.5 cm(-1.4+/-1.3) from 149.7+/-6.4 cm(-2.1+/-1.3) before treatment(P=0.004). In PAH_H, there was no significant increase in PAH during the two years of treatment. During the first year of combination of GH and GnRHa, GV and PAH increased significantly. We observed significant increases in FAH, comparing to the initial PAH in the PAH_L and GnRHa+GH groups. The height gains(FAH-initial PAH) were significantly higher in the PAH_L and GnRHa+GH groups than that in the PAH_H group. CONCLUSION: This study suggests the FAH and height gains are improved in patients, whose predicted adult height before treatment was shorter than those with higher predicted adult height, with the treatment of GnRHa alone or in combination with GH. GH could not improve the final adult height, but compensated the growth in patients whose growth velocity was decelerated by GnRHa alone.
Adult* ; Female* ; Gonadotropin-Releasing Hormone* ; Growth Hormone* ; Humans ; Puberty, Precocious*

The effects of testosterone on the pituitary growth hormone (GH) response directly and to hypothalamic growth hormone-releasing hormone (GHRH) were evaluated in vitro using a male pituitary cell monolayer culture system. Wistar male rats were gonadectomized at 22 days of age, and 21 days later their anterior pituitaries were removed and trypsinized for cell dispersion. Testosterone 0, 0.1, 1.0, 10.0 nM was added to the medium for 1 day and GH amounts in media were measured. In another experiment, testosterone 1, 0.1, 1.0, 5.0, 10,0 nM was added to the medioum for 3 days, and subsequently 5 nM GHRH was added for 1 day, thereafter GH amounts in media were measured. The results were as follows: 1) The increase of GH response after testosterone administration to the cultured rat pituitary cell was not significant. 2) The rat pituitary cell response to GHRH was augmented after pretreatment with testosterone. These results are suggested that testosterone has no direct effect on GH secretion, but by increasing the pituitary cell response to GHRH, contributes to the regulation of GH secretion in vitro.
Animals ; Growth Hormone* ; Growth Hormone-Releasing Hormone ; Humans ; Male ; Rats* ; Testosterone* ; Trypsin

AIMTo research the effect of intermittent hypoxia during sleep on hypothalamus-pituitary-adrenal (HPA) axis and growth hormone (GH) level.

METHODSRats were respectively exposed to intermittent hypoxia, room air and continuous hypoxia, after 1 day, 3 days, 7 days and 30 days, mRNA levels of corticotropin-releasing hormone (CRH) and growth hormone releasing hormone (GHRH) in hypothalamus of rats were detected using RT-PCR, and the levels of CRH, GHRH, corticotropin(ACTH), cortex ketone, and growth hormone in plasma were measured.

RESULTSAfter 30 days, the CRH mRNA levels in rats hypothalamus which exposed to intermittent hypoxia were increased significantly than those exposed to continuous hypoxia as well as normal control but GHRH decreased, there was no difference between continuous hypoxia and normal control. After 1 day, 3 days, and 7 days, there was no difference between continuous hypoxia and intermittent hypoxia. After 30 days, the plasmic level of CRH,ACTH and cortex ketone increased, GHRH decreased and GH had no obvious change.

CONCLUSIONThe rats' HPA axis level increases and GHRH restrained with chronic intermittent hypoxia during sleep, feedback regulation disorders.

Animals ; Corticotropin-Releasing Hormone ; metabolism ; Growth Hormone ; metabolism ; Growth Hormone-Releasing Hormone ; metabolism ; Hypothalamo-Hypophyseal System ; Hypoxia ; Male ; Pituitary-Adrenal System ; Rats ; Rats, Wistar ; Sleep Apnea Syndromes ; metabolism

PURPOSE: The aim of this study was to determine whether there is a feedback relationship between pituitary growth hormone (GH) and gastric ghrelin. METHODS: We intravenously administered 10 microgram of either rat ghrelin or normal saline to adult male Sprague-Dawley rats and then measured the plasma GH levels and the mRNA expression levels of pituitary GH mRNA and hypothalamic GH-releasing hormone (GHRH) mRNA. Human GH (500 microgram/kg, twice a day) or normal saline was subcutaneously administered to rats with or without food for 3 days. Thereafter, the plasma ghrelin levels and the ghrelin mRNA levels in the stomach were measured. RESULTS: The plasma GH levels increased more significantly in rats that were administered ghrelin than in controls (P<0.05). The mRNA levels of pituitary GH and hypothalamic GHRH were similar in the 2 groups. The plasma ghrelin levels and the stomach ghrelin mRNA levels were not affected by GH administration. Fasting significantly increased plasma ghrelin levels (P<0.05) and stomach ghrelin mRNA levels (P<0.05). CONCLUSION: Exogenous ghrelin administration only stimulated GH secretion without stimulating the synthesis of GH and GHRH. The synthesis and secretion of ghrelin were not suppressed by exogenous GH administration. These findings indicate that there is no feedback relationship between pituitary GH and gastric ghrelin.
Adult ; Animals ; Fasting ; Ghrelin ; Growth Hormone ; Growth Hormone-Releasing Hormone ; Humans ; Male ; Plasma ; Rats ; Rats, Sprague-Dawley ; RNA, Messenger ; Stomach

PURPOSE: There is controversy surrounding the growth outcomes of treatment with gonadotropin-releasing hormone agonist (GnRHa) in central precocious puberty (CPP). We analyzed height preservation after treatment with GnRHa with and without growth hormone (GH) in girls with CPP. METHODS: We reviewed the medical records of 82 girls with idiopathic CPP who had been treated with GnRHa at Severance Children's Hospital from 2004 to 2014. We assessed the changes in height standard deviation score (SDS) for bone age (BA), and compared adult height (AH) with midparental height (MPH) and predicted adult height (PAH) during treatment in groups received GnRHa alone (n=59) or GnRHa plus GH (n=23). RESULTS: In the GnRHa alone group, the height SDS for BA was increased during treatment. AH (160.4+/-4.23 cm) was significantly higher than the initial PAH (156.6+/-3.96 cm) (P<0.001), and it was similar to the MPH (159.9+/-3.52 cm). In the GnRHa plus GH group, the height SDS for BA was also increased during treatment. AH (159.3+/-5.33 cm) was also higher than the initial PAH (154.6+/-2.55 cm) (P<0.001), which was similar to the MPH (158.1+/-3.31 cm). Height gain was slightly higher than that in the GnRHa alone group, however it statistically showed no significant correlation with GH treatment. CONCLUSION: In CPP girls treated with GnRHa, the height SDS for BA was increased, and the AH was higher than the initial PAH. Combined GH treatment showed a limited increase in height gain.
Adult* ; Female ; Gonadotropin-Releasing Hormone* ; Growth Hormone* ; Humans ; Medical Records ; Puberty, Precocious* ; Treatment Outcome

PURPOSE: Gonadotropin releasing hormone analogue (GnRHa) or growth hormone (GH) improve final height in girls with central precocious puberty. We studied the effect of these agents on adult height in children with advanced puberty. METHODS: We analysed height, bone age, growth velocity, predicted adult height (PAH), and final adult height (FAH) in 61 girls and 19 boys with advanced puberty, who were treated with GnRHa combined GH or GH. RESULTS: In Girls 1) FAH (SDS) of combination group (GnRHa+GH, n=7) was similar to their pretreatment PAH (SDS) [153.9+/-6.0 cm (-1.3+/-1.2) vs 152.8+/-4.7 cm (-1.5+/-0.9)]. In GH group (n=18), FAH was significantly increased [155.7+/-4.9 cm (-0.9+/-1.0) vs 149.9+/-4.6 cm (-2.1+/-0.9)] (P<0.001). 2) PAH (SDS) of combination group increased from 151.5+/-5.9 cm (-1.8+/-1.2) to 157.8+/-7.1 cm (-0.5+/-1.4) and that of GH group increased from 149.5+/-5.9 cm (-2.2+/-1.2) to 155.8+/-5.8 cm (-0.9+/-1.2) (P<0.001). During first year of treatment, growth velocity of GH group was significantly higher than that of combination group (6.6+/-2.1 cm/year vs 9.4+/-2.5 cm/year, P=0.001) In boys 1) In both group (7 boys of combination group and 8 boys of GH group), FAH was similar to their pretreatment PAH and their growth velocity during first year of treatment had no significant difference (7.6+/-2.3 cm/year vs 9.2+/-2.9 cm/year). CONCLUSION: In girls with advanced puberty, GnRHa delayed bone maturation but had no significant effect on FAH. In contrast, GH increased FAH through increment of growth velociy. In boys with advanced puberty, no significant effect of GnRHa or GH.
Adolescent ; Adult ; Child* ; Female ; Gonadotropin-Releasing Hormone* ; Gonadotropins* ; Growth Hormone* ; Humans ; Puberty* ; Puberty, Precocious

PURPOSE: Many recent studies have been performed to improve adult height in short normal girls with early puberty by arresting rapid pubertal progression. We evaluated the effect of combined therapy with growth hormone (GH) and gonadotropin releasing hormone agonist (GnRHa) on predicted adult height in girls with early puberty, comparing them with a group treated with GnRHa alone. METHODS: Twenty eight girls with early puberty were classified into two groups and treated for an average 18 months. Group I of 18 girls was treated with GnRHa alone (leuprolide acetate; dosage: 30-90 mcg/kg, s.c. every 28 days) and group II of 10 girls was treated in combination with GH (dosage: 0.1 IU/kg, s.c. 5-7 days/week). Two groups were compared in terms of bone age, height, sexual maturity, and predicted adult height at the start and after the treatment. RESULTS: Two groups were not significantly different from each other in chronologic age, bone age, weight, target height, and sexual maturity before and after treatment. After treatment, group I showed predicted adult height (157.1+/-6.2 cm) which was comparable to target height (157.1+/-3.7 cm) and was not significantly higher than predicted adult height before treatment (156.0+/-6.5). On the contrary, group II showed predicted adult height (158.5+/-4.6 cm) which was comparable to target height (156.2+/-3.6 cm), but significantly higher than predicted adult height before treatment (154.2+/-7.4 cm) (P<0.05). CONCLUSIONS: GH and GnRHa combination treatment is more effective than GnRHa treatment alone to improve predicted adult height in girls with early puberty.
Adolescent ; Adult* ; Female* ; Gonadotropin-Releasing Hormone* ; Gonadotropins* ; Growth Hormone* ; Humans ; Puberty*

PURPOSE: The aim of this study was to assess the usefulness of growth velocity at 3 months after gonadotropinreleasing hormone (GnRH) agonist treatment as a predictive value of 1 year growth velocity after treatment in girls with precocious puberty. METHODS: We studied 30 Korean girls with precocious puberty whose chronologic and bone age were less than 9 years and 11 years old, respectively at diagnosis. They treated with a 4 week interval GnRH agonist subcutaneous injections for at least more than 1 year. The patients who were treated with growth hormone simultaneously excluded for this study. Data were collected from chart review retrospectively. We measured heights and calculated growth velocities of the subjects at 3 months and 1 year after GnRH agonist treatment. RESULTS: The mean chronologic age and bone age of the subjects were 8.3 +/- 0.8 year and 10.4 +/- 0.6 years, respectively. The growth velocity at 3 months, 6 months, 9 months and 1 year after GnRH agonist treatment were 7.1 +/- 2.6, 6.6 +/- 2.1, 5.7 +/- 1.3 and 5.8 +/- 0.9 cm/yr, respectively. The positive correlation between the growth velocity at 3 months and 6 months, 9 months, 1 year after GnRH agonist treatment were shown(P < 0.001, P < 0.001, P = 0.002, respectively). CONCLUSION: In this study, the growth velocity at 1 year after GnRH agonist treatment may be predicted by the growth velocity at 3 months after treatment. The patient whose growth velocity at 3 months after GnRH agnoist treatment was low would be needed to observe the growth pattern carefully and to consider combined growth hormone treatment, if needed. It may be deserve further studies to improve final height in patients with central precocious puberty in various conditions.
Gonadotropin-Releasing Hormone ; Growth Hormone ; Humans ; Injections, Subcutaneous ; Puberty, Precocious ; Retrospective Studies