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GH secretion reserve in subclinical hypercortisolism

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Abstract

Purpose

In overt hypercortisolism, growth hormone (GH) secretion is decreased and normalizes after surgery. In subclinical hypercortisolism (SH), GH secretion has been scarcely investigated. We assessed GH reserve in patients with and without SH and, in the former, also after recovery.

Methods

We enrolled 24 patients with adrenal adenomas, 12 with SH (SH+, 8 females, 58.3 ± 6.5 years) and 12 without SH (SH−; 11 females, 61.8 ± 10.6 years). SH was diagnosed in the presence of ≥2 out of: 1 mg overnight dexamethasone suppression test >83 nmol/L, urinary free cortisol (UFC) >193 nmol/day and ACTH levels <2.2 pmol/L. GH secretion was assessed by GHRH + Arginine test (GHRH–ARG) and age-adjusted serum IGF-I levels, expressed as SDS (IGF-I SDS). Eight SH+ patients were re-evaluated after the recovery from SH.

Results

Age, gender, body mass index (BMI) and IGF-I SDS were comparable between SH+ and SH− patients. After GHRH–ARG the mean GH peak levels (GH-P) and GH response (as Area Under Curve, GH-AUC) were lower in SH+ than in SH− patients (15.2 ± 8.1 vs 44.5 ± 30.9 μg/L, P = 0.004 and 1,418 ± 803 vs 4,028 ± 2,476 μg/L/120 min, P = 0.002, respectively), after adjusting for age and BMI. The GH-AUC and GH-P levels were negatively associated with UFC after adjusting for age and BMI (β = −0.39, P = 0.02 and β = −0.4, P = 0.020 respectively). After recovery, GH-P levels and GH-AUC increased as compared to baseline (23.7 ± 16.3 vs 15.8 ± 10.2 μg/L, P = 0.036 and 2,549 ± 1,982 vs 1,618 ± 911 μg/L/120 min, P = 0.012, respectively).

Conclusions

GH secretion reserve is decreased in SH patients and increases after the recovery.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Standards

The study was conducted in accordance with applicable laws.

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Authors and Affiliations

  1. Department of Clinical Sciences and Community Health, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, University of Milan, Milan, Italy

    Serena Palmieri, Valentina Morelli, Cristina Eller-Vainicher, Elisa Cairoli, Volha V. Zhukouskaya, Paolo Beck-Peccoz & Iacopo Chiodini

  2. Unit of Endocrinology “Casa Sollievo della Sofferenza”, IRCCS, San Giovanni Rotondo, FG, Italy

    Antonio Stefano Salcuni & Alfredo Scillitani

Authors
  1. Serena Palmieri
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  2. Valentina Morelli
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  3. Antonio Stefano Salcuni
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  4. Cristina Eller-Vainicher
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  5. Elisa Cairoli
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  6. Volha V. Zhukouskaya
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  7. Paolo Beck-Peccoz
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  8. Alfredo Scillitani
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  9. Iacopo Chiodini
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Corresponding author

Correspondence to Serena Palmieri.

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Palmieri, S., Morelli, V., Salcuni, A.S. et al. GH secretion reserve in subclinical hypercortisolism. Pituitary 17, 470–476 (2014). https://doi.org/10.1007/s11102-013-0528-7

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  • DOI: https://doi.org/10.1007/s11102-013-0528-7

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