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Pituitary release of growth hormone & prolactin in the primary fibromyalgia (FM) syndrome

OBJECTIVE. Previously, we demonstrated hyperreactive

adrenocorticotropic hormone (ACTH) release in patients with

primary fibromyalgia syndrome (primary FMS). We investigated

the pituitary release of growth hormone (GH) and prolactin

(PRL) in search of further disturbances in neuroendocrine

reactivity possibly associated with the pathophysiology of

primary FMS.

METHODS. Ten female patients with primary FMS

fulfilling the 1981 Yunus criteria and 10 matched, healthy and

sedentary controls were subjected to an insulin induced

hypoglycemia test; samples for measurement of glucose, GH and

PRL were taken at intervals.

RESULTS. Compared to the

controls, the patients with primary FMS displayed

significantly lower basal GH levels, whereas their basal PRL

levels were slightly, though significantly, higher

(respectively p = 0.021 and p = 0.041). Following

hypoglycemia, there was a marked, statistically highly

significant (p = 0.001), hyperreactivity of the GH response in

patients with primary FMS. The PRL response showed wide

interindividual variation and did not differ between patients

and controls.

CONCLUSION. Our findings indicate that

fibromyalgia, along with ACTH hyperreactivity, also exhibits a

distinct disturbance in the GH-somatomedin C axis. With regard

to PRL, the variation in individual responses limits

conclusions. The hyperreactive response patterns of GH and

ACTH previously suggest a common origin, which might be

related to a subtle glucocorticoid deficiency.

Griep EN, Boersma JW, de Kloet ER