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Research on Fibromyalgia
The growth hormone (GH)-releasing hormone-GH-insulin-like
growth factor- 1 axis in patients with fibromyalgia syndrome.
| AUTHORS:
| Leal-Cerro A; Povedano J; Astorga
R; Gonzalez M; Silva H; Garcia-Pesquera F; Casanueva FF; Dieguez C
| AUTHOR AFFILIATION:
| Department of Endocrinology,
Hospital Universitario Virgen del Rocio, Sevilla, Spain.
| SOURCE:
| J Clin Endocrinol Metab 1999
Sep;84(9):3378-81
| CITATION IDS:
| PMID: 10487713 UI: 99415654
| ABSTRACT:
| Fibromyalgia (FM) is a painful
syndrome of nonarticular origin, characterized by fatigue and widespread
musculoskeletal pain, tiredness, and sleep disturbances, without any other
objective findings on examination. Interestingly, some of the clinical
features of FM resemble the ones described in the adult GH-deficiency
syndrome. Furthermore, insulin-like growth factor (IGF)-1 levels are
frequently reduced in patients with FM. To gain further insight into the
mechanisms leading to dysregulation of the GH-IGF-1 axis in these
patients, we assessed 24-h spontaneous GH secretion, GH responses to GHRH,
and IGF-1 and IGF binding protein (BP)-3 levels before and after 4 days
treatment with human (h)GH. We found that, in comparison with controls,
patients with FM exhibited a marked decrease in spontaneous GH secretion
as assessed by mean GH secretion (2.5 +/- 0.4 microg/L in controls vs. 1.2
+/- 0.1 microg/L in FM, P < 0.05), pulse height (4.7 +/- 0.8 microg/L
in controls vs. 2.5 +/- 0.3 microg/L in FM, P < 0.05), and pulse area
(4.7 +/- 1 min/mg x L in controls vs. 2.3 +/- 0.3 min/mg x L in FM, P <
0.05). In contrast, GH responses to GHRH (100 microg, i.v.) were similar
in controls (mean peak, 13.5 +/- 2.5 microg/L) and in patients with FM
(12.2 +/- 3 microg/L). Finally, treatment with hGH (2 IU, s.c. daily),
over 4 days, led to a clear-cut increase in plasma IGF-1 and IGFBP-3
levels in patients with FM. In conclusion, our data show that patients
with FM exhibited a marked decrease in spontaneous GH secretion, but
normal pituitary responsiveness to exogenously administered GHRH, thus
suggesting the existence of an alteration at the hypothalamic level in the
neuroendocrine control of GH in these patients. Furthermore, our finding
of increased IGF-1 and IGFBP-3 levels after GH treatment, over 4 days,
opens up the possibility of testing the therapeutic potential of hGH in
patients with FM.
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