J. Golstein

Insulin-like growth factor I : a good indicator of functional hepatocellular capacity in alcoholic liver cirrhosis

To assess the value of serum insulinlike growth factor I (IGF-I) determination in liver disease, 21 patients hospitalized for active alcoholic cirrhosis (19 males, 2 females), 56 ± 2 y (mean ± SE) were studied at admission. Individual scores of hepatic alterations (Child score) ranged from 6 to 12 (mean: 9 ± 1). Basal IGF-I levels were dramatically decreased, averaging 0.11 ± 0.02 U/ml vs 0.70 ± 0.08 U/ml in 15 control subjects. In cirrhotic patients, IGF-I values were inversely correlated with the modified Child index (r= −0.57, p < 0.01). A highly significant positive correlation (r = 0.68, p < 0.001) was evidenced between IGF-I levels and aminopyrine breath test values (which provide quantitative estimates of the hepatic functional capacity). In contrast, no significant relationship was found between IGF-I levels and various nutritional parameters (albumin, prealbumin, retinol binding protein) after partial correlation analysis. The present data suggest that, in alcoholic cirrhosis, the decrease of circulating IGF-I values is mainly related to alterations of liver function, and that IGF-I can be used as a good indicator of functional hepatocellular capacity.

Asymptomatic autoimmune thyroiditis and coronary heart disease. Cross sectional and prospective studies

Cross sectional and prospective surveys of thyroid autoimmunity have been performed in two cohorts of men, 280 living in west Finland and 269 in east Finland. In both populations, aged 50 to 69 years at the first survey, risk factors for coronary heart-disease (C.H.D.) were common. The incidence of C.H.D. was shown to be related to the presence of thyroid antibodies. The results of the cross-sectional studies were not conclusive. The five-year follow-up study emphasised that in both areas asymptomatic thyroid autoimmunity, independently of other known risk factors, was a predictor of subsequent development of C.H.D. The importance of asymptomatic autoimmune thyroid-itis as a risk factor for C.H.D. increases with age.

Thyrotropin nyctohemeral pattern in primary depression : Differences between unipolar and bipolar women

Abstract The nyctohemeral patterns of serum thyrotropin (TSH) levels were studied in thirteen female patients suffering from primary affective illness (5 bipolars and 8 unipolars); they were compared to the nyctohemeral profiles obtained in six normal female subjects. The periodogram analysis showed striking differences in TSH circadian rhythms between unipolar and bipolar patients. The nyctohemeral TSH patterns in bipolar patients were similar to those obtained in controls. Unipolar patients, compared to controls, had a significantly lower 24-hour TSH mean, a lower sleep-wake ratio of TSH and an absence of nocturnal rise of TSH. The alterations of the circadian rhythm of TSH secretion observed in the depressive phase of unipolar illness may be a relevant neuroendocrine indicator of hypothalamic-pituitary dysfunction in primary depressive illness.

Effects of oral contraceptive therapy on the circadian patterns of cortisol and thyrotropin (TSH)

Abstract. The daily variation of serum cortisol and thyrotropin (TSH) has been simultaneously recorded every 30‐min. in 4 women taking the same oral contraceptive containing oestrogens and progestogens and in 4 control women. The circadian rhythm of cortisol persisted under contraceptive therapy with about a 2.5 fold elevation of the mean level and amplitude of the basal rhythm. Theoretical equilibrium calculations of the circadian variations of the free, transcortin‐bound and albumin‐bound cortisol fractions showed that these elevations are explained qualitatively and quantitatively by an oestrogen‐induced increase of the same order of the transcortin cortisol‐binding sites. As a consequence of the already high saturation of transcortin in normal conditions, the magnitude of the variation of free cortisol level resulting from a burst in cortisol secretion varies with the time of day. The role of albumin as a buffer is thereby emphasized. The early morning maximum, characterizing the normal TSH daily pattern, appeared to be considerably enhanced in women under contraceptive therapy. If the circadian variations of TSH are driven by thyrotropir releasing hormone (TRH), these higher morning peaks probably reflect a higher burst of TRH secretion rather than an increased responsiveness of the pituitary to TRH secretion induced by contraceptive therapy. Finall these results do not support the hypothesis of a regulation of TSH circadian variations by an inhibiotry action of cortisol. Contraceptive therapy does not appear to play a role at the level of the central clock or on the resetting mechanism.

ACUTE ENDOCRINE PROFILE OF SULPIRIDE IN THE HUMAN

Normal men and normally menstruating women received i.m. injections of 0.1 to 4.0 mg/kg sulphide. This psychotropic drug induced a very rapid (already significant after 5 minutes) and sustained (still significant after 7 hours) elevation of prolactin (PRL) concentrations in all subjects with no consistent modification of LH and FSH. After injection of 4.0 mg/kg, there was similarly no modification of mean TSH concentrations in the women tested in the luteal phase, as well as of mean GH levels in men. Sulpiride prevented the inhibitory effect on PRL levels of 500 mg levodopa, administered orally simultaneously; levodopa administered 2 hours prior to sulpiride failed to counteract the PRL‐stimulatory effect of sulpiride. Under chronic sulpiride‐induced hyperprolactinaemia, levodopa exhibited however a very slight inhibitory effect on PRL concentrations. These data are in agreement with the hypothesis that sulpiride acts mainly at the pituitary level by blocking dopamine receptors of the lactotropes and support the concept that the menstrual cycle perturbations observed under chronic sulpiride administration result from hyperprolactinaemia itself or from a mechanism quite similar to that by which sulpiride induces hyperprolactinaemia.

Specific inhibition by somatostatin of growth hormone release after hypoglycaemia in normal man

In normal man, synthetic linear somatostatin (growth hormone‐release inhibiting hormone) inhibits the growth hormone response to insulin induced hypoglycaemia, but has no influence on plasma levels of cortisol, prolactin, TSH and FSH.

Influence of thyrotropin-free serum on the radioimmunoassay of human thyrotropin.

Abstract The addition of thyrotropin-free serum to the reagents of the standard curve modifies the results of thyrotropin measurements in human serum. This modification, related to a decrease in the antibody-bound labelled human thyrotropin and to a shift to the left of the standard curve, varies greatly according to the anti-human thyrotropin antiserum used. It is suggested that the standard curve is performed systematically in thyrotropin-free serum in order to standardize the human thyrotropin levels measured with different antisera.

Enhanced ACTH and blunted cortisol responses to corticotropin-releasing factor in idiopathic panhypopituitarism

ADM IN 1STRATION of corticotropin-reteasing factor has been shown to stimulate the release of ACTH and cortisol in normal humans? -4 In one patient with hypothalamic anterior pituitary failure, Miiller et al? found a normal ACTH response without cortisol elevation. The purpose of our study was to assess the characteristics of the pituitaryadrenal responsiveness to CRF in a group of six patients with nontumoral idiopathic panhypopituitarism. METHODS Six patients (five males) with nontumoral idiopathic panhypopituitarism, aged 12 to 29 years, were examined, with informed consent. All patients had delayed growth and bone maturation. All were shown to have blunted responses of hGH and of cortisol to both insulin intravenously and glucagon intramuscularly 5 and absence of an increase of plasma l l-deoxycortisol or urinary 17hydroxysteroids after metyrapone. Serum dehydroepiandrosterone sulfate concentration ~was <100 ng/ml in all patients. All had tertiary hypothyroidism as assessed by TSH response to TRH, and gonadotropin deficiency as assessed by lowered LH and FSH responses to LH-RH and absence of spontaneous pubertal development. Skull radiographs were normal. All patients had been receiving hormonal substitutive therapy for several years. The two oldest patients (patients 4 and 5) were not receiving growth hormone treatment at the time of the study. Corticoid treatment had been stopped for 2 years in patient 4 and at

LONG‐ACTING THYROID STIMULATOR AND THYROID FUNCTION IN RELATIVES OF PATIENTS WITH GRAVES’DISEASE

In ten families, fifty relatives and seven husbands of ten patients with untreated Graves’disease were submitted to clinical examination, biological and immunological investigations. They were compared with fifty control subjects. In the relatives, thyroid diseases were found in 26%, positive LATS‐IgG responses in 30%, thyroid antibodies in 23% and abnormal NBEI in 30%. The mean LATS response was significantly greater than in controls. With one exception no overt hyperthyroidism was found in the relatives on the basis of serum PBI, T3 resin uptake test, total T4 and TSH level. From the analysis of the pedigrees, no definite mode of inheritance can be found for LATS and NBEI. These data suggest the existence of a thyroid metabolic anomaly in the families of patients with thyrotoxicosis and argue against LATS as the cause of the hyperthyroidism of Graves’disease.

Effects of dexamethasone and secobarbital on the pituitary response to thyrotropin releasing hormone (TRH) in man: synergistic inhibition of thyrotropin (TSH) release

The present study was made to investigate the possible effects of dexamethasone and secobarbital on the pituitary responses of prolactin (PRL) and TSH to TRH. Dexamethasone (1 mg) and secobarbital (10