PULSATILE GH/PROLACTIN SECRETION IN NORMALS AND PATIENTS WITH PITUITARY ADENOMAS

该项目的主要目的是研究垂体腺瘤患者生长激素和催乳素分泌的脉动性。这些多肽在循环中的半衰期相对较短，而且它们是以脉冲形式分泌的，这限制了对单一激素测量的解释和生理意义。最近的研究已经证明了人类生长激素和催乳素分泌的脉动性。类似的研究还没有在功能性或非功能性腺瘤患者中进行，特别是在手术切除腺瘤之后。我们目前依靠垂体激素动态研究对腺瘤患者进行详细评估，并评估手术后的长期结果。虽然这种方法非常有用，但这些反应可能不能代表正常的生理学。研究这些患者的搏动性激素分泌应该为动态研究提供额外的生理学意义。我们已经确定了健康个体激素分泌的脉动模式，并将使用这些数据与垂体腺瘤患者的数据进行比较。目前的研究将仅限于腺瘤患者，在手术前或手术后进行研究。虽然有限，但数据显示腺瘤患者的催乳素释放呈脉冲性。然而，与正常人相比，脉搏频率降低了。手术治疗成功后，脉搏频率和幅度接近正常。术后夜间催乳素释放相对增加，昼夜比值接近正常值。共有11名已知的垂体腺瘤患者接受了研究。6名患者在手术前接受研究，另外5名患者在术后数月至数年内接受评估。数据的公布将被推迟，直到更多的手术治疗患者被研究。

The main goal of this project is to investigate the pulsatile nature of growth hormone and prolactin secretion in patients with pituitary adenomas. The relatively short half-life of these peptides in the circulation and the fact that they are secreted in pulses, limits interpretation of, and the physiologic significance of single hormone measurements. Recent studies have demonstrated the pulsatile nature of growth hormone and prolactin secretion in humans. Similar studies have not been conducted in patients with functioning or non functioning adenomas especially after surgical adenomectomy. We currently rely on pituitary hormone dynamic studies in the detailed evaluation of patients with adenomas and in assessing the long term outcome after surgery. While this approach has been very useful, the responses may not be representative of normal physiology. Investigating pulsatile hormone secretion in these patients should provide additional physiological significance to the dynamic studies. We have already determined the pulsatile pattern of hormone secretion in healthy individuals and will use the data for comparison to that of patients with pituitary adenomas. The current study will be limited to patients with adenomas, studied before or after surgery. Though limited, the data show pulsatile prolactin release in patients with adenomas. The pulse frequency was, however, decreased when compared to normal individuals. After successful surgical treatment, pulse frequency and amplitude are similar to normal. After surgery, there was a relative increase in nocturnal release of prolactin such that the ratio of night/day levels was similar to that of normal. A total of 11 patients with known pituitary adenomas have already been studied. Six were studied before surgery while five others were evaluated months to years postoperatively. Publication of the data will be delayed until more surgically treated patients are studied.