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The growth hormone (GH)-releasing hormone-GH-insulin-like growth

  [ 370 votes ]   [ Discuss This Article ] • September 4, 1999

Fibromyalgia (FM) is a painful syndrome of nonarticular
origin, characterized by fatigue and widespread
musculoskeletal pain, tiredness, and sleep disturbances,
without any other objective findings on examination.
Interestingly, some of the clinical features of FM resemble
the ones described in the adult GH-deficiency syndrome.
Furthermore, insulin-like growth factor (IGF)-1 levels are
frequently reduced in patients with FM. To gain further
insight into the mechanisms leading to dysregulation of the
GH-IGF-1 axis in these patients, we assessed 24-h spontaneous
GH secretion, GH responses to GHRH, and IGF-1 and IGF binding
protein (BP)-3 levels before and after 4 days treatment with
human (h)GH. We found that, in comparison with controls,
patients with FM exhibited a marked decrease in spontaneous GH
secretion as assessed by mean GH secretion (2.5 +/- 0.4
microg/L in controls vs. 1.2 +/- 0.1 microg/L in FM, P <
0.05), pulse height (4.7 +/- 0.8 microg/L in controls vs. 2.5
+/- 0.3 microg/L in FM, P < 0.05), and pulse area (4.7 +/- 1
min/mg x L in controls vs. 2.3 +/- 0.3 min/mg x L in FM, P <
0.05). In contrast, GH responses to GHRH (100 microg, i.v.)
were similar in controls (mean peak, 13.5 +/- 2.5 microg/L)
and in patients with FM (12.2 +/- 3 microg/L). Finally,
treatment with hGH (2 IU, s.c. daily), over 4 days, led to a
clear-cut increase in plasma IGF-1 and IGFBP-3 levels in
patients with FM. In conclusion, our data show that patients
with FM exhibited a marked decrease in spontaneous GH
secretion, but normal pituitary responsiveness to exogenously
administered GHRH, thus suggesting the existence of an
alteration at the hypothalamic level in the neuroendocrine
control of GH in these patients. Furthermore, our finding of
increased IGF-1 and IGFBP-3 levels after GH treatment, over 4
days, opens up the possibility of testing the therapeutic
potential of hGH in patients with FM.

Leal-Cerro A, Povedano J, Astorga R, Gonzalez M, Silva H,
Garcia-Pesquera F, Casanueva FF, Dieguez C

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