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Patients with severe PGBH usually have diffuse hyperinsulinism without localization on SACST

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In addition, an inverse doseresponse relationship is evident between blood glucose concentrations and handgrip strength [18] and between higher hemoglobin A1c (HbA1c) within the normal range and lower knee extensor strength [69]

Studies examining cortisol, growth hormone, and other pituitary hormones have generally not demonstrated clinically significant direct effects, though data are limited

This leads to pulsatile growth hormone secretion rather than constant external hormone exposure

Kiel DW, Dodson EA, Artal R, Boehmer TK, Leet TL