Growth hormone in infant malnutrition: the arginine test in marasmus and kwashiorkor

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Abstract
1. Experiments in children and in animals seem to demonstrate that in marasmic malnutrition there is a reduction in the secretion of growth hormone. To study this problem the fasting, resting plasma concentrations of growth hormone were determined, before, and 45 and 60 min after, stimulation with an intravenous dose of arginine, in six infants with marasmus, in six infants with kwashiorkor and in five normal infants.2. The values of plasma growth hormone (4·5 ± 0·97 ng/ml) in marasmic infants were significantly (P < 0·001) lower than those of the controls (7·8 ± 2·6 ng/ml), and responded little to stimulation with arginine (5·1 and 5·8 ng/ml at 45 and 60 min respectively), in contrast to those in the control group, which rose to 16·4 and 14·6 ng/ml. In children with kwashiorkor the values were very variable, but generally high, and showed little response (25·6 ± 13·3 before and 25·0 ± 17·6 and 14·2 ± 5·3 ng/ml at 45 and 60 min after stimulation respectively).3. These results demonstrate that the responses of the hypophysis to deprivation of calories and protein (marasmus) and to protein deprivation (kwashiorkor) are different: in marasmus there is a progressive adaptation, with low secretion and poor reaction to stimulation, whereas in kwashiorkor the process is acute with high basal values of plasma growth hormone.