Document Detail


Reduced epinephrine reserve in response to insulin-induced hypoglycemia in patients with pituitary adenoma.
MedLine Citation:
PMID:  17766707     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Hypoglycemia induces rapid secretion of counterregulatory hormones such as catecholamine, glucagon, cortisol, and GH. Insulin-induced hypoglycemia is used for evaluating GH-IGF-I and ACTH-adrenal axes in patients with pituitary disorders. The aim of this study was to determine whether the response of catecholamine secretion to hypoglycemia is disrupted in patients with pituitary adenoma. METHODS: The study population comprised 23 patients with pituitary adenoma (non-functioning adenoma or prolactinoma). An insulin tolerance test was performed and serum catecholamines as well as plasma GH and serum cortisol were measured. RESULTS: The study patients showed diminished response of plasma epinephrine to insulin-induced hypoglycemia. With the cutoff level of peak epinephrine for defining severe impairment set at 400 pg/ml, more patients with secondary adrenal insufficiency showed severe impairment of the epinephrine response than did those without it. Peak epinephrine levels to insulin-induced hypoglycemia were significantly correlated with peak cortisol levels. In patients with secondary hypothyroidism, secondary hypogonadism, GH deficiency, or diabetes insipidus, the prevalence of severe impairment of the epinephrine response was similar to that in patients without these deficiencies. CONCLUSIONS: Impaired epinephrine secretion in response to insulin-induced hypoglycemia was frequently observed in patients with pituitary adenoma. This disorder was especially severe in patients with secondary adrenal insufficiency.
Authors:
Shinya Morita; Michio Otsuki; Maki Izumi; Nobuyuki Asanuma; Shuichi Izumoto; Youichi Saitoh; Toshiki Yoshimine; Soji Kasayama
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  157     ISSN:  0804-4643     ISO Abbreviation:  Eur. J. Endocrinol.     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-09-03     Completed Date:  2007-11-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  England    
Other Details:
Languages:  eng     Pagination:  265-70     Citation Subset:  IM    
Affiliation:
Department of Medicine, Osaka University Graduate School of Medicine, Yamada-Oka, Suita, Osaka, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adenoma / blood*,  complications,  diagnosis
Adrenal Insufficiency / blood*,  diagnosis,  etiology
Adult
Aged
Biological Markers / blood
Epinephrine / blood*
Female
Humans
Hypoglycemia / blood*,  chemically induced
Hypoglycemic Agents / diagnostic use
Insulin / diagnostic use
Male
Middle Aged
Norepinephrine / blood
Pituitary Neoplasms / blood*,  complications,  diagnosis
Prolactinoma / blood,  complications,  diagnosis
Severity of Illness Index
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Hypoglycemic Agents; 11061-68-0/Insulin; 51-41-2/Norepinephrine; 51-43-4/Epinephrine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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