Abstract：
OBJECTIVE: We previously showed the clinical characteristics of acromegaly with a paradoxical growth hormone (GH) response to oral glucose or thyrotropin-releasing hormone. However, the clinical characteristics of acromegaly with an increased GH response to luteinizing hormone-releasing hormone (LHRH responders) remain unclear. The aim of the present study was to evaluate the clinical characteristics, especially gonadotroph-related characteristics of LHRH responders in acromegaly.
METHODS: The clinical characteristics of 33 LHRH responders and 81 LHRH nonresponders were compared.
RESULTS: No differences in age, sex or basal serum levels of GH, insulin-like growth factor-1 (IGF-1), and gonadotropin were observed between the two groups. Steroidogenic factor 1 (SF-1), gonadotropin-releasing hormone receptor (GnRHR), and LH expression was more frequently observed in LHRH responders (P < 0.05). In addition, a greater increased rate of GH after LHRH loading, and the proportion of GnRHR and gonadotropin expression was observed in pituitary tumor with SF-1 expression than that without the expression (P < 0.01). LHRH responders showed a greater GH decrease in the octreotide test and a greater IGF-1 decrease after first-generation somatostatin ligand than LHRH nonresponders (P < 0.05). Furthermore, the proportion of hypointense pituitary tumors on T2-weighted magnetic resonance imaging and tumors with densely granulated type was higher in LHRH responders than in LHRH nonresponders, respectively (P < 0.05). No difference between the two groups was observed in either somatostatin receptor 2 or 5 expression.
CONCLUSIONS: The increased GH response to LHRH is associated with the gonadotroph-related characteristics. This response may reflect the biological characteristics of somatotroph tumors.
METHODS: The clinical characteristics of 33 LHRH responders and 81 LHRH nonresponders were compared.
RESULTS: No differences in age, sex or basal serum levels of GH, insulin-like growth factor-1 (IGF-1), and gonadotropin were observed between the two groups. Steroidogenic factor 1 (SF-1), gonadotropin-releasing hormone receptor (GnRHR), and LH expression was more frequently observed in LHRH responders (P < 0.05). In addition, a greater increased rate of GH after LHRH loading, and the proportion of GnRHR and gonadotropin expression was observed in pituitary tumor with SF-1 expression than that without the expression (P < 0.01). LHRH responders showed a greater GH decrease in the octreotide test and a greater IGF-1 decrease after first-generation somatostatin ligand than LHRH nonresponders (P < 0.05). Furthermore, the proportion of hypointense pituitary tumors on T2-weighted magnetic resonance imaging and tumors with densely granulated type was higher in LHRH responders than in LHRH nonresponders, respectively (P < 0.05). No difference between the two groups was observed in either somatostatin receptor 2 or 5 expression.
CONCLUSIONS: The increased GH response to LHRH is associated with the gonadotroph-related characteristics. This response may reflect the biological characteristics of somatotroph tumors.
摘要：
目的：我们先前显示了肢端肥大症的临床特征，对口服葡萄糖或促甲状腺激素释放激素有矛盾的生长激素（GH）反应。然而,肢端肥大症对促黄体生成素释放激素(LHRH反应者)的GH反应增加的临床特征仍不清楚.本研究的目的是评估临床特征，尤其是肢端肥大症中LHRH反应者的促性腺激素相关特征。
方法：比较了33例LHRH反应者和81例LHRH无反应者的临床特征。
结果：年龄无差异，GH的性别或基础血清水平，胰岛素样生长因子-1（IGF-1），观察两组患者的促性腺激素水平。类固醇生成因子1（SF-1），促性腺激素释放激素受体（GnRHR），LH表达在LHRH反应者中更常见(P<0.05)。此外,LHRH加载后GH的增加率更大，在有SF-1表达的垂体瘤中，GnRHR和促性腺激素的表达比例高于无表达的垂体瘤（P<0.01）。与LHRH无反应者相比，LHRH应答者在奥曲肽试验中显示出更大的GH下降，在第一代生长抑素配体后IGF-1下降更大（P<0.05）。此外，在T2加权磁共振成像和密集颗粒型肿瘤中，LHRH应答者的低脑垂体肿瘤的比例高于LHRH无应答者，分别为(P<0.05)。两组之间的生长抑素受体2或5表达均无差异。
结论：对LHRH的GH反应增加与促性腺激素相关特征相关。这种反应可能反映了生长激素肿瘤的生物学特性。
方法：比较了33例LHRH反应者和81例LHRH无反应者的临床特征。
结果：年龄无差异，GH的性别或基础血清水平，胰岛素样生长因子-1（IGF-1），观察两组患者的促性腺激素水平。类固醇生成因子1（SF-1），促性腺激素释放激素受体（GnRHR），LH表达在LHRH反应者中更常见(P<0.05)。此外,LHRH加载后GH的增加率更大，在有SF-1表达的垂体瘤中，GnRHR和促性腺激素的表达比例高于无表达的垂体瘤（P<0.01）。与LHRH无反应者相比，LHRH应答者在奥曲肽试验中显示出更大的GH下降，在第一代生长抑素配体后IGF-1下降更大（P<0.05）。此外，在T2加权磁共振成像和密集颗粒型肿瘤中，LHRH应答者的低脑垂体肿瘤的比例高于LHRH无应答者，分别为(P<0.05)。两组之间的生长抑素受体2或5表达均无差异。
结论：对LHRH的GH反应增加与促性腺激素相关特征相关。这种反应可能反映了生长激素肿瘤的生物学特性。
