Evaluation of postmortem serum and cerebrospinal fluid growth hormone levels in relation to the cause of death in forensic autopsy.

Previous studies have shown that postmortem serum levels of adrenocorticotropic hormone (ACTH) were significantly lower in cases of asphyxia and poisoning than in other groups, whereas ACTH levels in cerebrospinal fluid (CSF) were significantly lower for hypothermia and hyperthermia. This study comparatively analyzed growth hormone (GH) levels in serum and CSF in relation to cause of death in routine forensic work. Autopsy cases (n = 116), including cases of blunt injury, sharp instrument injury, fire fatality, asphyxia, drowning, hypothermia, and acute myocardial infarction/ischemia (AMI), were examined. GH concentrations were measured using an immunoradiometric assay technique. GH levels in serum were significantly higher in cases of blunt injury, sharp instrument injury, hypothermia, and AMI than in the other groups. GH levels in CSF were significantly higher in fire fatality cases with a high COHb level than in the other groups. In a previous study ACTH immunopositivity in the adenohypophysis was significantly higher in cases of blunt injury, fire fatality, and AMI whereas GH immunopositivity was not significantly different among the groups, although positivity was higher in cases of fire fatality with a low COHb level. These observations suggest that postmortem serum/CSF GH and ACTH levels in acute deaths change differently, depending on the cause of death, because of varied stress reactions of the hypothalamic-pituitary-adrenal (HPA) axis.