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. 2013:2013:159858.
doi: 10.1155/2013/159858. Epub 2013 Nov 21.

Investigation of responsiveness to thyrotropin-releasing hormone in growth hormone-producing pituitary adenomas

Sang Ouk Chin  1 , Sang Youl Rhee  1 , Suk Chon  1 , You-Cheol Hwang  1 , In-Kyung Jeong  1 , Seungjoon Oh  1 , Sung-Woon Kim  1
Affiliations

Investigation of responsiveness to thyrotropin-releasing hormone in growth hormone-producing pituitary adenomas

Sang Ouk Chin et al. Int J Endocrinol. 2013.

Abstract

Objective. The aim of this study was to investigate how the paradoxical response of GH secretion to TRH changes according to tumor volumes. Methods. Patients with newly diagnosed acromegaly were classified as either TRH responders or nonresponders according to the results of a TRH stimulation test (TST), and their clinical characteristics were compared according to responsiveness to TRH and tumor volumes. Results. A total of 41 acromegalic patients who underwent the TST were included in this study. Between TRH responders and nonresponders, basal GH, IGF-I levels, peak GH levels, and tumor volume were not significantly different, but the between-group difference of GH levels remained near significant over the entire TST time. ΔGHmax-min during the TST were significantly different according to the responsiveness to TRH. Peak GH levels and ΔGHmax-min during the TST showed significantly positive correlations with tumor volume with higher levels in macroadenomas than in microadenomas. GH levels over the entire TST time also remained significantly higher in macroadenomas than in microadenomas. Conclusion. Our data demonstrated that the paradoxical response of GH secretion to TRH in GH-producing pituitary adenomas was not inversely correlated with tumor volumes.

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Figures

Figure 1
Figure 1
Comparison of GH levels according to the responsiveness to TRH during the entire TST time. Data represent mean ± standard error. RMANOVA was used for the statistical comparison, and Greenhouse-Geisser correction was applied if compound symmetry was not satisfied based upon Mauchly's sphericity test. Abbreviations: GH: growth hormone; TRH: thyrotropin releasing hormone; TST: TRH stimulation test; RMANOVA: repeated measure one-way analysis of variance.
Figure 2
Figure 2
Comparison of GH levels between macroadenomas and microadenomas during the TST. Data represent mean ± standard error. RMANOVA was used for the statistical comparison, and Greenhouse-Geisser correction was applied if compound symmetry was not satisfied based upon Mauchly's sphericity test. Abbreviations: GH: growth hormone; TRH: thyrotropin releasing hormone; TST: TRH stimulation test; macro: macroadenoma; micro: microadenoma; RMANOVA: repeated measure one-way analysis of variance.
Figure 3
Figure 3
Correlation between the tumor volume and peak GH levels during the TST (r = 0.498, P = 0.001) (a) and ΔGHmax-min during the TST (r = 0.420, P = 0.006) (b).
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