Response of human growth hormone, prolactin and thyrotropin to thyrotropin releasing hormone in liver cirrhosis and diabetes mellitus.

Abstract

Serum HGH, PRL and TSH responses to intravenous injection of 500μg of TRH were investigated in nine patients with liver cirrhosis and in patients of the same number with diabetes mellitus who served as controls. They were roughly matched in age, sex and body weight. The basal serum HGH levels in the cirrhotic group were significantly high with a value of 4.7±1.7ng/ml compared to the values of 1.5±0.9ng/ml in the control diabetic group. Serum HGH levels in the cirrhotic group at 15, 30, 60 and 90min intervals after TRH were significantly higher than the basal serum HGH levels. The control diabetic group showed no positive response. Similar responses were observed again in three subjects of the cirrhotic group after treatment for hepatic insufficiency. Two subjects of the cirrhotic group showed an elevation of serum HGH in response to TRH even under hyperglycemia induced by glucose administration. The basal serum PRL levels were identical in both groups. The serum PRL levels in both groups evidently increased in response to TRH with significantly higher response in the cirrhotic group than in the control diabetic group at15, 30 and 60min intervals after TRH. There was no significant difference in the basal levels of serum TSH or the levels after TRH between both groups. It was concluded that the serum HGH levels in cirrhotic patients were elevated by TRH. Since the response was independent of clinical severity, the possibility exists that it could be attributed to some basic metabolic abnormality of the underlying liver cirrhosis. Since the abnormal HGH response to TRH was not seen in the control diabetic group and was not altered by hyperglycemia in the cirrhotic group, an abnormality of the glucose metabolism was eliminated as a possible cause.