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48 PHYSIOLOGICAL GH SECRETION DURING THE RECOVERY FROM PSYCHOSOCIAL DWARFISM: THE PATTERN OF GH PULSATILITY IS REPRODUCIBLE

We have studied 11 prepubertal children (5F, 6M) with subnormal growth velocities and adverse psychosocial factors within in the family; 5 patients had been sexually abused. Mean age was 8.0 yrs (range, 3.8 - 13.6). All were admitted to hospital for a 3 week period with only limited parental access. Serial serum sampling for GH at 15 minute intervals for 18 hours was performed on 3 occasions during each admission with sleep monitored by EEG.4 patients had GH insufficiency which reversed between day 2 and day 6 of their admission. Two patients had GH insufficiency which did not alter during their admission; they both had an excellent anthropometric response to GH treatment. Five children had normal GH profiles which remained unaltered.The recovery of GH secretion in psychosocial dwarfism was achieved by an increase in pulse amplitude with no alteration in pulse frequency. These observations provide further evidence that the control of GH secretion is by pulse amplitude modulation.There was a variable relationship between slow-wave sleep and GH secretion. The patients who had irreversible GH insufficiency had 3 identical GH secretory profiles. In the patients who had normal GH secretion and in those after recovery from psychosocial dwarfism, the pattern of GH pulsatility, the size and timing of GH peaks, and the shape of GH pulses were reproducible for each individual patient.