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Changes in growth hormone, insulin, insulinlike growth factors (IGFs), & IGF-binding protein-1 in CFS

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Chronic fatigue syndrome (CFS) is characterized by severe physical

and mental fatigue of central origin. Similar clinical

features may occur in disorders of the hypothalamopituitary

axis. The aim of the study was to determine whether patients

with CFS have abnormalities of the growth hormone/insulinlike

growth factor (GH-IGF) axis basally or following hypothalamic

stimulation with insulin-induced hypoglycemia. We compared

levels of GH, IGF-I, IGF-II, IGF-binding protein-1 (IGFBP-1),

insulin, and C-peptide in nondepressed CFS patients and

normal controls. We found attenuated basal levels of IGF-I

(214 +/- 17 vs. 263.4 +/- 13.4 micrograms/L, p = .036) and

IGF-II (420 +/- 19.8 vs. 536 +/- 24.3 micrograms/L, p = .02)

in CFS patients and a reduced GH response to hypoglycemia

(peak GH; 41.9 +/- 11.5 vs. 106.0 +/- 25.6 mU/L, p = .017).

Insulin levels were higher (7.6 +/- 1.0 vs. 4.3 +/- 0.8 mU/L,

p = .02) and IGFBP-1 levels were lower (19.7 +/- 4.6 vs. 43.2

+/- 2.7 mg/L, p = .004) in CFS patients compared with

controls. This study provides preliminary data abnormalities

of the GH-IGF axis in CFS. It is not apparent whether these

changes are components of a primary pathological process or

are acquired secondary to behavioral aspects of CFS such as

reduced physical activity.

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