GLUCONEOGENIC AND BRANCH CHAIN AMINO ACID STUDIES IN HYPOPITUITARISM

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Gluconeogenic amino acid and branch chain amino acid studies were performed on 8 growth hormone deficient patients without spontaneous hypoglycemia compared to constitutional short children. New information on alanine, glycine, glutamine and leucine was obtained comparing fasting versus 30 minute response to S.C. Glucagon 30 ug/kg. Comparable fasting and gluconeogenic hypoaminoacidemic responses to Glucagon occurred in all study groups, i.e., controls, pre-hGH therapy, post-hGH therapy, Anavar, and hGH plus Anavar. However, plasma branch chain amino acid leucine delta (Δ) absolute reduction in response to Glucagon was enhanced in hGH deficient children on Anavar alone or in combination with hGH. Plasma leucine absolute change (Δ) pre-hGH -18±4uM S.E.M., on Anavar −27±4 S.E.M. (p <0.05) and hGH plus Anavar −34±3 S.E.M. (<0.01). Thus branch chain but not gluconeogenic amino acid was affected by the anabolic nature of Anavar and growth hormone. Lower fasting glucose and insulin values with blunted responses to Glucagon were noted in hGH deficient children. Asymptomatic hGH deficient patients failed to show fasting hypoalaninemia or abnormal (Δ) response to Glucagon, suggesting that hGH deficiency alone does not lead to gluconeogenic substrate-limited disorder. Whereas an additional ketotic hypoglycemic patient studied with both hGH and ACTH deficiency did show blunted hypoalaninemic response to Glucagon, i.e., Δ-10μM pre-therapy; Δ-20μM on hGH and Δ-130μM on cortisone. hGH support by the National Hormone and Pituitary Program.