448 INTERACTIVE EFFECTS OF ACTH AND GROWTH HORMONE ON ADRENOCORTICAL HORMONE SECRETION

Abstract

The effects of ACTH and growth hormone (GH) on adrenocortical hormone secretion were studied in a 13-year-old girl with GH and thyrotropin deficiency but normal ACTH function. Cortisol secretion was measured by the sum of the urinary excretions of tetra-hydrocortisol (THF), allotetrahydrocortisol (ATHF), and tetra-hydrocortisone (THE). Adrenal androgen secretion was measured by the sum of androsterone (A) and etiocholanolone (E). The patient took a constant daily dose of desiccated thyroid (150 mg) during 5 successive periods: 3-day control, 3 days of I.M. ACTH (0.5 mg/kg daily), 12-day post-ACTH control, 6 days of I.M. human GH (3.5 mg daily),and 3 days of ACTH + GH at the previous doses. Control excretion of THF + ATHF + THE was 6.0 mg/g creatinine and of A + E was 2.9 mg/g creatinine; these values confirm normal endogenous ACTH function. Taking these levels as 100, excretion of cortisol and androgen metabolites rose to 240 and 190 respectively during ACTH and decreased to 107 and 105 respectively during the last 3 days of the post-ACTH control period. During the GH period, they fell to 66 and 72 respectively. When ACTH was added to GH, they rose to 170 and 103 respectively. Thus GH given alone depressed secretion of both cortisol and adrenal androgens; this could be due to depression of endogenous ACTH secretion or to interference with the effect of ACTH on the adrenal. The data from the combined GH-ACTH period are compatible with either mechanism.

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