Growth hormone releasing hormone or growth hormone treatment in growth hormone insufficiency?
Smith. P J PJ; Brook. C G CG
Key Findings
- Pulsatile GHRH‑1‑40 (4‑8 µg/kg/day) produced growth in 73% of children, while twice‑daily GHRH‑1‑29 (8‑16 µg/kg/day) worked in 63%.
- Doubling the daily dose of GHRH‑1‑29 was needed to match the growth response of pulsatile GHRH‑1‑40.
- Direct growth‑hormone therapy gave a significantly better height‑velocity increase than either GHRH regimen.
Practical Outcomes
- For DIY users, the data suggest that if you choose a GHRH peptide, a pulsatile dosing schedule (short bursts) may be more effective than simple twice‑daily dosing, and you may need a higher total daily dose of GHRH‑1‑29 to see comparable results. However, conventional growth‑hormone injections remain the most potent option for true GH deficiency.
Summary
In a small study of kids with low growth hormone, giving the natural hormone-releasing peptide (GHRH) helped some grow, but the standard growth‑hormone shots worked better. The longer‑acting peptide (GHRH‑1‑40) given in short nightly bursts was more effective than the shorter version (GHRH‑1‑29) taken twice a day, unless the dose of the short version was doubled.
Abstract
Sixteen prepubertal children who were insufficient for growth hormone were treated with growth hormone releasing hormone (GHRH) 1-40 and GHRH 1-29 for a mean time of nine months (range 6-12 months) with each peptide. Eleven children received GHRH 1-40 in four subcutaneous nocturnal pulses (dose 4-8 micrograms/kg/day) and eight (three of whom were also treated with GHRH 1-40) received GHRH 1-29 twice daily (dose 8-16 micrograms/kg/day). Altogether 73% of the children receiving GHRH 1-40 and 63% receiving GHRH 1-29 showed a growth response. Double the daily dose of GHRH 1-29 was required to obtain equivalent growth response to pulsatile GHRH 1-40. A significant linear correlation was shown between growth hormone secretion and height velocity on GHRH 1-40 but not on GHRH 1-29 and there was a significant correlation between plasma GHRH and serum growth hormone concentrations during GHRH 1-40 administration. Response to conventional growth hormone treatment in a matched group of children was significantly better than the response after GHRH. A significant improvement in height velocity was observed in the children transferred to growth hormone replacement. Growth hormone remains the treatment of choice in growth hormone insufficiency. GHRH treatment may be of benefit in children with less severe growth hormone insufficiency in the presence of pulsatile endogenous growth hormone secretion.
Study Information
pubmed
1988
1988-06-01T00:00:00.000Z
10.1136/adc.63.6.629
16
19