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- Edén Engström, Britt
(författare)
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Growth Hormone and Gender. Studies in Healthy Adults and in Patients with Growth Hormone Disorders
- 2001
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The use of a new, more sensitive immunoassay for growth hormone (GH) revealed that the serum levels in men were lower than expected in sera drawn ambulatory in the morning after an overnight fast and that the gender difference was more than 10 times greater than reported. These observations led to a more thorough study on the impact of gender and sex steroids on the levels of GH and other hormones in ambulatory morning samples and over a 24-hour period. Furthermore, the impact of gender was studied in GH deficient (GHD) patients and healthy young adults treated with GH, and in patients with acromegaly treated with octreotide. An 80-fold gender difference in the morning GH levels was observed in young individuals as a reaction to ambulation, with decreased levels in men and increased in women. Oral contraceptives (OCs) given to women further increased the morning GH levels. During the day, higher outputs of epinephrine and lower levels of GH were seen in the men, while no gender differences were seen at night. The gender difference in morning GH levels decreased with age due to opposite changes in men and women. Administration of 17β-estradiol (E2) via subcutaneous implants in postmenopausal women, which increased the E2-concentrations to luteal phase levels, had no effect on the morning GH levels, indicating that the different reactions to ambulation do not appear to result from a direct sex steroid effect alone. Short-term administration of GH to young, healthy adults resulted in larger effects on insulin-like growth factor I (IGF-I) and other key metabolic parameters in men than in women. The smallest response was noted in women taking OCs. The clinical studies involving long-term GH treatment of patients with GHD demonstrate a gender difference in GH responsiveness, with women being less sensitive than men, a fact which should have a therapeutic impact in patients with GH disorders. A further gender difference of therapeutic importance was observed in men and women with acromegaly. Long-term treatment with a slow-release formulation of octreotide resulted in higher IGF-I levels in the men, despite equal doses of the drug and similar levels of GH.
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- Johannsson, Gudmundur, 1960, et al.
(författare)
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Low dose dehydroepiandrosterone affects behavior in hypopituitary androgen-deficient women: a placebo-controlled trial.
- 2002
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Ingår i: The Journal of clinical endocrinology and metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 87:5, s. 2046-52
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Tidskriftsartikel (refereegranskat)abstract
- Thirty-eight women, aged 25-65 yr, with androgen deficiency due to hypopituitarism were treated with oral dehydroepiandrosterone (DHEA; 30 mg/d if <45 yr of age and 20 mg if > or =45 yr of age) for 6 months in a randomized, placebo-controlled, double blind study, followed by a 6-month open treatment period. The administration of DHEA raised the serum levels of DHEAS to normal age-related reference ranges and increased androstenedione and T to subnormal levels. Androgen effects on skin and/or pubic and/or axillary hair were observed in 84% (32 of 38) of the women after all received 6 months of DHEA treatment. No such effects were observed after the placebo treatment. These effects after 6 months were correlated with the serum levels of DHEAS (r = 0.37; P = 0.03), androstenedione (r = 0.42; P = 0.01), and T (r = 0.37; P = 0.03). The percentages of partners who reported improved alertness, stamina, and initiative by their spouses were 70%, 64%, and 55%, respectively, in the DHEA group and 11%, 6%, and 11%, respectively, in the placebo group (P < 0.05). According to the partners, sexual relations tended to improve compared with placebo (P = 0.06). After 6 months of treatment, increased sexual interest or activity was reported by 50% of the women taking 30 mg DHEA, by none taking 20 mg DHEA, and by two women taking placebo (P = NS). Compared with levels after placebo administration, high density lipoprotein cholesterol and apolipoprotein A-1 levels decreased after DHEA. Serum concentrations of IGF-I, serum markers of bone metabolism, and bone density did not change. In conclusion, oral administration of a low dose of DHEA to adult hypopituitary women induced androgen effects on skin and axillary and pubic hair as well as changes in behavior, with only minor effects on metabolism.
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