Subject(s)
Diabetes Mellitus, Type 1/drug therapy , Insulin/therapeutic use , Adolescent , Adult , Child , Female , Humans , Insulin/immunology , Insulin Antibodies/analysis , MaleABSTRACT
The effects of an iv thyrotropin releasing hormone (TRH) bolus on serum growth hormone (GH) and cortisol levels were evaluated in 59 children and adolescents with insulin dependent diabetes mellitus (IDDM) and in 24 healthy, age-matched control subjects. In the IDDM group GH baseline levels sharply rose within 30 min after TRH and successively normalized. On the contrary, TRH injection failed to affect GH serum concentrations in the control group. The GH increase after TRH in IDDM patients was positively correlated to age, but unrelated to other variables, such as sex, pubertal stage, duration of disease, glycemia, glycosylated hemoglobin, thyrotropin and T4 concentrations. Twenty-one out of 59 diabetics and only 1/24 controls exhibited a paradoxical GH response to TRH, arbitrarily defined as a precocious increase (within 30 min), of more than 100% with respect to the baseline value, associated with a GH peak greater than 10 ng/ml. Eighteen IDDM patients underwent a second TRH test 12 to 24 months later and substantially exhibited the same GH pattern documented the first time. The mechanism responsible for such anomalous GH responsiveness to TRH in IDDM is unclear. However, it cannot be attributed to a nonspecific stress reaction, as proven by the lack of a concomitant increase of cortisol serum levels in the same subjects.
Subject(s)
Diabetes Mellitus, Type 1/blood , Growth Hormone/blood , Hydrocortisone/blood , Thyrotropin-Releasing Hormone/pharmacology , Adolescent , Age Factors , Child , Female , Humans , MaleABSTRACT
Two groups of children presenting with micropenis (penis length less than or equal to 2.5 cm) were treated according to 2 different therapeutic schedules. The first consisted of the transcutaneous administration of testosterone propionate (4 mg twice a day) and the second of the intramuscular injection of sustained action testosterone enanthate (25 mg every 2 weeks). Only the intramuscular treatment was able to induce a normal and durable penis growth, owing to the hyperplastic action that the testosterone injection exerted on the level of the cellular tissues of the penis. Using testosterone enanthate dosages varying from 25 to 50 mg, the risks for an abnormal acceleration of growth and bone age seem to be minimized.