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B. L. Herrmann, K. Mann, O. E. Janssen
Diagnostik des Wachstumshormonmangels und des Wachstumshormonexzesses (Akromegalie) / Diagnostics of growth hormone deficiency and excess (acromegaly)
Growth hormone (GH) is synthesized in the anterior lobe of the pituitary gland and has a plasma half-life of 19 minutes. GH-secretion is regulated by hypothalamic releasing hormone (GHRH) stimulation and somatostatin inhibition. The major effect of GH is the stimulation of insulin-like growth factor-1 (IGF-1) synthesis and secretion by the liver. However, GH also has other biological effects through other mediators. Serum-IGF-1 is bound to IGF binding protein-3 (IGFBP-3) and to acid-labile subunit (ALS). The GH/IGF-1-axis is evaluated when either GH-deficiency (GHD) or GH-excess (acromegaly) are suspected. GHD is confirmed by a diminished GHresponse to insulin-induced hypoglycemia (normal range GH >5 ?g/l) or to administration of GHRH+arginine (normal range GH >9 ?g/l). Acromegaly has distinct clinical signs and is confirmed when GH can not be suppressed below 1 ?g/l by an oral glucose tolerance test in combination with elevated IGF-1 levels adjusted for age.
LaboratoriumsMedizin, Walter de Gruyter
Print ISSN: 0025-8466
Volume: 28, 04/2004
Pages: 127 - 134