Energy Homeostasis in Hypopituitary Children and Controls

Abstract

27 children aged 4-16 yrs with hypopituitarism were studied before (I) and after 6 months of growth hormone therapy (II) and compared with 15 endocrinologically normal children aged 2-12 yrs (8 short stature & 7 suspected hypoglycemia) (III). Plasma glucose (G), insulin (IRI), glucagon (IRG), free fatty acids (FFA) and β-hydroxybutyrate (BOH) were measured serially during a fast and following intravenous glucagon administration which terminated the fast after a maximum of 24 hrs. The mean G nadir during the fast was 51 mg% in I, 44 mg% in II and 44 mg% in III. The glucagon stimulated G rise was significant (35 mg% in I, 33 mg% in II and 35 mg% in III). The FFA concentrations at 0 time were .59, .57 & .67 meq/1 in I, II and III respectively. In all 3 groups there was a significant increase of FFA to 1.67, 1.70 & 2.06 meq/1 in I, II & III resp. There were no intergroup differences in any of these results. BOH rose equally in groups I & II. There was a significant IRG rise during the fast of 200 pg/ml in I, 197 pg/ml in II & 234 pg/ml in III. Basal IRI values and IRI responses to glucagon were not different in I & II, but significantly higher than III at both times. The higher IRI values in I & II reflect the frequently associated obesity, particularly in older children. We conclude that energy homeostasis in hypopituitarism during fasting is associated with appropriate fat mobilization, ketone production and IRG responses. In 4 patients in I & 2 in III who became hypoglycemic (G<40 mg%) responses were similar.

Log in or create a free account to read this content

Gain free access to this article, as well as selected content from this journal and more on nature.com

Access through your institution

or

Sign in or create an account

Continue with Google

Continue with ORCiD