Sweat and vitamin D status in congenital, lifetime, untreated GH deficiency
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RESEARCH LETTER
Sweat and vitamin D status in congenital, lifetime, untreated GH deficiency Cynthia S. Barros-Oliveira1 Roberto Salvatori 2 Jéssica S. S. dos Santos1 Paula F. C. Santos1 Alécia A. Oliveira-Santos1 Cindi G. Marinho1 Elenilde G. Santos1 Ângela C. G. B. Leal1 Viviane C. Campos1 Nayra P. Damascena1 Carla R. P. Oliveira1 Manuel H. Aguiar-Oliveira1 ●
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Received: 22 May 2019 / Accepted: 28 June 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Purpose A reciprocal relationship exists between the skin and the GH/IGF-I axis. Skin produces both IGF- I and vitamin D, and GH and IGF-I exert several actions in the skin. Reduced sweating and altered phosphor-calcium homeostasis are occasionally reported in subjects with GH deficiency (GHD), mostly in the setting of hypopituitarism, therefore associated to other hormonal deficiencies. It is unclear whether these findings are due to GHD. The aim of this study was to assess skin function in subjects with isolated GHD (IGHD) due to a mutation in the GHRH receptor gene. Methods In a cross-sectional study we enrolled 20 IGHD and 20 local controls. Sweating (volume, conductivity and chloride content) was assessed by a 30 min pilocarpine iontophoresis test, using the Macroduct® Sweat Collection System. IGF-I, Insulin, PTH, 25-hydroxyvitamin D, C-reactive protein (CRP), CPK, glucose, calcium, phosphate, alkaline phosphatase, total proteins and fractions, urinary calcium, and insulin were measured. HOMA-IR was calculated. Results IGHD presented lower sweating, but normal vitamin D and phosphor-calcium homeostasis. Additionally, IGHD subjects presented lower HOMA-IR, higher CRP and reduced CPK. Conclusion Untreated IGHD cause reduction in sweating, but does not affect phosphor-calcium homeostasis. KeyWords GH deficiency skin sweat vitamin D ●
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Introduction Skin has many functions, some protective (against microorganisms, dehydration, ultraviolet light, and mechanical damage) and other homeostatic (sweating and production of vitamin D). A mutual influence exists between the skin and the growth hormone/insulin growth factor I (GH/IGF-I) axis. Skin produces IGF-I and vitamin D, and GH and IGF-I exert several actions on the skin [1, 2]. Therefore, alterations of the GH–IGF-I axis may influence sweating and the phosphorus–calcium homeostasis.
* Roberto Salvatori [email protected] 1
Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe 49060-100, Brazil
2
Division of Endocrinology, Diabetes and Metabolism, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
Sweating is essential for thermoregulation, exercise capacity, and exposure to high ambient temperatures [3]. Patients with childhood-onset GH deficiency (COGHD) have impaired sweating ability [3]. Sweating impairment has been also reported in men with adult-onset GHD [4]. Laron’s dwarfs, affected by GH insensitivity, also exhibit impaired sweating ability [5]. During exposure to sunli
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