Somatotropic axis in hypocretin-deficient narcoleptic humans: altered circadian distribution of GH-secretory events

Am J Physiol Endocrinol Metab. 2003 Mar;284(3):E641-7. doi: 10.1152/ajpendo.00421.2002. Epub 2002 Nov 26.

Abstract

Narcolepsy is a sleep disorder caused by impaired hypocretin (orexin) neurotransmission. Growth hormone (GH) secretion may be altered in narcolepsy for various reasons. Slow-wave sleep episodes, which are closely associated with GH-secretory events, are more randomly dispersed over 24 h in narcoleptics. Furthermore, hypocretins may inhibit pituitary GH release. We assessed the function of the somatotropic axis in narcolepsy by deconvolving 24-h (10-min sampling interval) plasma GH concentration profiles in seven hypocretin-deficient narcoleptic patients and in seven healthy controls matched for age, sex, and body weight. Both basal and pulsatile GH secretion rate and secretagogue-induced GH release were similar in patients and controls. However, narcoleptics secreted approximately 50% of their total production during the daytime, whereas controls secreted only 25% during the day. Also, the GH output pattern of narcoleptics was significantly less regular. We propose that hypocretin deficiency disrupts the circadian distribution of hypothalamic GH-releasing hormone release in narcoleptic patients to simultaneously cause daytime GH release and promote their propensity to fall asleep during the day.

MeSH terms

  • Adult
  • Aged
  • Carrier Proteins
  • Circadian Rhythm*
  • Growth Hormone / blood*
  • Growth Hormone / metabolism*
  • Growth Hormone-Releasing Hormone / pharmacology
  • Humans
  • Injections, Intravenous
  • Intracellular Signaling Peptides and Proteins*
  • Metabolism, Inborn Errors / complications
  • Metabolism, Inborn Errors / metabolism
  • Middle Aged
  • Narcolepsy / etiology
  • Narcolepsy / metabolism*
  • Neuropeptides / deficiency*
  • Orexins
  • Reference Values
  • Sleep

Substances

  • Carrier Proteins
  • Intracellular Signaling Peptides and Proteins
  • Neuropeptides
  • Orexins
  • Growth Hormone
  • Growth Hormone-Releasing Hormone