Growth hormone (GH) secretion disorders have been reported in poorly controlled type I diabetes mellitus patients. Our work was aimed to evaluate GH secretion in 9 type I young diabetes mellitus patients as well as the low molecular weight IGF-binding protein secretion (IGFBP-1) in 5 of them. The patients did not show any signs of malnutrition or neurovascular complications, neither were they on any medication except for insulin. The study protocol included blood samples collection during a 24-h period for measurement of glucose, glycated hemoglobin, GH IGF-I and IGFBP-1 levels under two situations: on poor glycemic control and after 2-3 months on better control through systematic diet, low in carbohydrates and increase in insulin dosage. GH secretion data were analyzed by Cluster algorithm for pulsatility parameters; for rhythm assessment Cosinor method was used. The first study (poor control) reported significant increase of GH maximal and incremental amplitude and duration pulse values, when compared to the second study (better control). Mean 24-h secretion values as well mean GH for interpulse intervals (valleys) decreased, although not statistically significant. The fraction of pulsatile GH/24 h GH did not change significantly with better glycemic control. No changes in pulse frequency were observed. Mean IGF-I concentrations were significantly higher when patients were on better glycemic control. An ultradian variation for GH secretion was noticed in the first study (poor control) and a circadian variation in the second one (better control). IGFBP-1 analysis showed significant decrease of the mean 24-h values under better glycemic control. Linear regression analysis demonstrated a correlation between IGFBP-1 levels and fasting glucose levels. A circadian variation was present in IGFBP-1 secretion, irrespective of glycemic control. Therefore, we concluded that for type I diabetic patients: 1. GH secretion is increased on poor control, through maximal, incremental amplitude and pulse duration values; 2. IGFBP-1 values were significantly reduced and IGF-1 levels significantly higher after better glycemic control; 4. GH ultradian secretion is reported on poor control, and circadian on the better one, 5. IGFBP-1 circadian secretion occurred irrespective of glycemic control.

Adolescent↗

PubMedDate not supplied

Non-conjugated versus total urinary cortisol in the diagnosis of Cushing's syndrome.

The radioimmunoassay of, urinary cortisol extracted by organic solvent (non-conjugated cortisol) has been used in the diagnosis of hypercortisolism for a long time. With the development of more specific antisera it became possible to measure urinary cortisol without extraction (total urinary cortisol). We compared both methods in the hypercortisolism diagnosis. Basal 24-hour urinary cortisol levels from 43 normal subjects, 53 obese patients and 53 Cushing's syndrome patients were measured. Urinary cortisol levels were not statistically different in normal and obese group in either methods (p > 0.05). There was a significant difference for the Cushing's syndrome group in relation to the normal and obese groups in both methods (p < 0.05). Sensitivity was similar for both methods and a positive correlation was noticed in the three groups. We conclude that both methods are efficient for the diagnosis of hypercortisolism but we suggest that total urinary cortisol should be the first choice to diagnose Cushing's syndrome considering its advantages such as low cost and feasibility.

Adolescent↗

PubMedDate not supplied