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Growth Hormone and Insulin-like Growth Factor-1 Concentrations in Women with Fibromyalgia
JENNIFER S. McCALL-HOSENFELD, DON L. GOLDENBERG, SHELLEY HURWITZ, and GAIL K. ADLER
ABSTRACT.
Methods. Premenopausal women with FM (n = 24) and premenopausal healthy women (n = 27) were studied. IGF-1 was measured in 23 patients with FM and 25 controls. GH was measured during a stepped hypoglycemic hyperinsulinemic clamp procedure (blood glucose decreased from 90 to 40 mg/dl every 30 min in 10 mg/dl decrements) in 12 FM and 13 control subjects. Results. IGF-1 concentrations were similar in the FM (200 ± 71 ng/ml, mean ± SD) and control (184 ± 70 ng/ml) groups. By multiple variable analysis, IGF-1 was negatively associated with age (p = 0.0006), body mass index (BMI) (p = 0.006), and 24 h urinary free cortisol (p = 0.007) in healthy controls. Even after accounting for these factors, there was no association between FM and IGF-1. The average peak GH achieved during hypoglycemia was lower in patients with FM (range 5 to 58 ng/ml, median 13 ng/ml) versus controls (6 to 68 ng/ml, median 21 ng/ml) (p = 0.04). However, BMI was a significant predictor of average peak GH in FM (r = -0.62, p < 0.01) and control subjects (r = -0.40, p = 0.06). After considering BMI, there was no significant association between FM subjects and the average peak GH (p = 0.20). Conclusion. In this sample of premenopausal women with FM, the activity of the GH-IGF-1 axis was similar to that of healthy controls. Increases in age and obesity were both strongly associated with lower activity of this axis, suggesting that these factors must be considered when studying activity of the GH-IGF-1 axis in FM. (J Rheumatol 2003;30:809-14) Key Indexing Terms:
FIBROMYALGIA
From the Endocrine-Hypertension Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School; and Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA. Supported by NIH Grant RO1 AR43130 to G.K.A. from the National Institute of Arthritis, Musculoskeletal and Skin Diseases, and by NIH Grant NCRR GCRC MO1 RR02635 to the Brigham and Women's Hospital General Clinical Research Center. J.S. McCall-Hosenfeld, AB, Harvard Medical School; G.K. Adler, MD, PhD; S. Hurwitz, PhD, Endocrine-Hypertension Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School; D.L. Goldenberg, MD, Division of Rheumatology, Newton-Wellesley Hospital, Newton, MA; Department of Medicine, Tufts University School of Medicine. Address reprint requests to Dr. G.K. Adler, Endocrine-Hypertension Division, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115. Submitted May 23, 2002; revision accepted October 18, 2002. |