The Effect of 30 Months of Low-Dose Replacement Therapy with Recombinant Human Growth Hormone (rhGH) on Insulin and C-Peptide Kinetics, Insulin Secretion, Insulin Sensitivity, Glucose Effectiveness, and Body Composition in GH-Deficient Adults
Autor: | Jannik Hilsted, S. Maghsoudi, Jens Otto Lunde Jørgensen, Anne Mette Rosenfalck, Aage Vølund, Sanne Fisker, J. S. Christiansen, Sten Madsbad |
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Rok vydání: | 2000 |
Předmět: |
Adult
Blood Glucose medicine.medical_specialty Time Factors Hormone Replacement Therapy Pituitary Diseases Endocrinology Diabetes and Metabolism medicine.medical_treatment Clinical Biochemistry Biology Carbohydrate metabolism Biochemistry Body Mass Index Placebos Impaired glucose tolerance chemistry.chemical_compound Endocrinology Insulin resistance Double-Blind Method Bone Density Internal medicine Diabetes mellitus Insulin Secretion medicine Humans Insulin Insulin-Like Growth Factor I Glucose tolerance test C-Peptide medicine.diagnostic_test Human Growth Hormone C-peptide Biochemistry (medical) Glucose Tolerance Test medicine.disease chemistry Area Under Curve Body Composition Lean body mass Insulin Resistance Follow-Up Studies |
Zdroj: | The Journal of Clinical Endocrinology & Metabolism. 85:4173-4181 |
ISSN: | 1945-7197 0021-972X |
Popis: | The aim of the present study was to evaluate the long-term (30 months) metabolic effects of recombinant human GH (rhGH) given in a mean dose of 6.7 microg/kg x day (= 1.6 IU/day), in 11 patients with adult GH deficiency. Glucose metabolism was evaluated by an oral glucose tolerance test and an iv (frequently sampled iv glucose tolerance test) glucose tolerance test, and body composition was estimated by dual-energy x-ray absorptiometry. Treatment with rhGH induced persistent favorable changes in body composition, with a 10% increase in lean body mass (P < 0.001) and a 12% reduction of fat mass (P < 0.002); however, the glucose tolerance deteriorated significantly, and three patients developed impaired glucose tolerance. Fasting insulin level (P < 0.003) and the homeostasis model assessment insulin resistance score increased significantly, indicating a deterioration in insulin sensitivity; whereas the insulin sensitivity index, calculated from the frequently sampled iv glucose tolerance test, only decreased slightly. The clearance of C-peptide and insulin increased 100% and 60%, respectively, and the prehepatic insulin secretion was tripled during rhGH treatment; but related to the impairment in glucose tolerance, beta-cell response was still inappropriate. Our conclusion is that long-term rhGH-replacement therapy in GH deficiency adults induced a significant deterioration in glucose tolerance, profound changes in kinetics of C-peptide, and insulin and prehepatic insulin secretion, despite an increase in lean body mass and a reduction of fat mass. Therefore, rhGH treatment may precipitate diabetes in some patients already susceptible to the disorder. |
Databáze: | OpenAIRE |
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