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Barros-Oliveira CS, Salvatori R, Dos Santos JSS, Santos PFC, Oliveira-Santos AA, Marinho CG, Santos EG, Leal ÂCGB, Campos VC, Damascena NP, Oliveira CRP, Aguiar-Oliveira MH. Sweat and vitamin D status in congenital, lifetime, untreated GH deficiency. Endocrine 2019; 65:710-713. [PMID: 31292841 DOI: 10.1007/s12020-019-01998-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 06/28/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE A reciprocal relationship exists between the skin and the GH/IGF-I axis. Skin produces both IGF- I and vitamin D, and GH and IGF-I exert several actions in the skin. Reduced sweating and altered phosphor-calcium homeostasis are occasionally reported in subjects with GH deficiency (GHD), mostly in the setting of hypopituitarism, therefore associated to other hormonal deficiencies. It is unclear whether these findings are due to GHD. The aim of this study was to assess skin function in subjects with isolated GHD (IGHD) due to a mutation in the GHRH receptor gene. METHODS In a cross-sectional study we enrolled 20 IGHD and 20 local controls. Sweating (volume, conductivity and chloride content) was assessed by a 30 min pilocarpine iontophoresis test, using the Macroduct® Sweat Collection System. IGF-I, Insulin, PTH, 25-hydroxyvitamin D, C-reactive protein (CRP), CPK, glucose, calcium, phosphate, alkaline phosphatase, total proteins and fractions, urinary calcium, and insulin were measured. HOMA-IR was calculated. RESULTS IGHD presented lower sweating, but normal vitamin D and phosphor-calcium homeostasis. Additionally, IGHD subjects presented lower HOMA-IR, higher CRP and reduced CPK. CONCLUSION Untreated IGHD cause reduction in sweating, but does not affect phosphor-calcium homeostasis.
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Affiliation(s)
| | - Roberto Salvatori
- Division of Endocrinology, Diabetes and Metabolism, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
| | - Jéssica S S Dos Santos
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
| | - Paula F C Santos
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
| | | | - Cindi G Marinho
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
| | - Elenilde G Santos
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
| | - Ângela C G B Leal
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
| | - Viviane C Campos
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
| | - Nayra P Damascena
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
| | - Carla R P Oliveira
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
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Oliveira-Santos AA, Salvatori R, Nogueira MC, Bueno AC, Barros-Oliveira CS, Leal ÂCGB, Marinho CG, Damascena NP, Oliveira DA, Melo MA, Oliveira CRP, da Costa FO, Dos Santos JSS, Santos PFC, Campos VC, Santos EG, Melo EV, Barbosa MLA, Rocha IES, de Castro M, Aguiar-Oliveira MH. Enteroendocrine Connections in Congenital Isolated GH Deficiency Due to a GHRH Receptor Gene Mutation. J Clin Endocrinol Metab 2019; 104:2777-2784. [PMID: 30860584 DOI: 10.1210/jc.2019-00094] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 03/06/2019] [Indexed: 12/25/2022]
Abstract
CONTEXT GH and IGF-1 are crucial for attainment of normal body size and regulation of food intake, nutrient storage, and insulin sensitivity. Enteroendocrine connections exist between the GH-IGF-1 axis and insulin, ghrelin, and glucagon-like peptide 1 (GLP-1). The status of these connections in GH deficiency (GHD) is unknown. OBJECTIVE To study the enteroendocrine connections before and after a standard meal test in a homogeneous population of adults with congenital untreated isolated GHD (IGHD) due to a mutation in the GHRH receptor gene. DESIGN In a cross-sectional study of 20 individuals with IGHD and 20 control subjects, we measured glucose, insulin, ghrelin, and GLP-1 before and 30, 60, 120, and 180 minutes after a standardized test meal. Homeostasis model assessment index of insulin resistance (HOMA-IR) and homeostasis model assessment (HOMA)-β were calculated. Participants scored feelings of hunger, fullness, and prospective food consumption on a visual analog scale. MAIN OUTCOME MEASURES Area under the curve (AUC) values of glucose, insulin, ghrelin, GLP-1, hunger, fullness, and prospective food consumption. RESULTS Fasting HOMA-IR and HOMA-β were lower in individuals with IGHD than in control subjects (P = 0.002 and P = 0.023, respectively). AUC was higher for hunger (P < 0.0001), glucose (P = 0.0157), ghrelin (P < 0.0001), and GLP-1 (P < 0.0001) and smaller for fullness (P < 0.0001) in individuals with IGHD compared with control subjects. There was no difference in AUC for prospective food consumption or insulin. CONCLUSIONS Untreated IGHD is associated with increased GLP-1 secretion and reduced postprandial ghrelin and hunger attenuation in response to a mixed meal. These enteroendocrine connections can result in a favorable outcome in terms of environmental adaptation and guaranteeing appropriate food intake and can confer metabolic benefits.
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Affiliation(s)
| | - Roberto Salvatori
- Division of Endocrinology and Metabolism, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Monica C Nogueira
- Department of Internal Medicine, The Ribeirao Preto Medical School, University of São Paulo Ribeirão Preto, São Paulo, Brazil
| | - Ana C Bueno
- Department of Internal Medicine, The Ribeirao Preto Medical School, University of São Paulo Ribeirão Preto, São Paulo, Brazil
| | | | - Ângela C G B Leal
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Cindi G Marinho
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Nayra P Damascena
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Djane A Oliveira
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Manuela A Melo
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Carla R P Oliveira
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Flavia O da Costa
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | | | - Paula F C Santos
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Viviane C Campos
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Elenilde G Santos
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Enaldo V Melo
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | | | - Ivina E S Rocha
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Margaret de Castro
- Department of Internal Medicine, The Ribeirao Preto Medical School, University of São Paulo Ribeirão Preto, São Paulo, Brazil
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