Titrating Growth Hormone Dose to High-Normal IGF-1 Levels Has Beneficial Effects on Body Fat Distribution and Microcirculatory Function Despite Causing Insulin Resistance

Autor: Mark H.H. Kramer, Madeleine L. Drent, Rick I. Meijer, Paul Lips, Erik H. Serné, Christa C van Bunderen
Přispěvatelé: Clinical, Neuro- & Developmental Psychology, IBBA, Internal medicine, Amsterdam Neuroscience - Mood, Anxiety, Psychosis, Stress & Sleep, APH - Aging & Later Life, VU University medical center, ACS - Diabetes & metabolism, ACS - Microcirculation, Amsterdam Gastroenterology Endocrinology Metabolism
Rok vydání: 2020
Předmět:
Adult
Male
medicine.medical_specialty
Waist
Endocrinology
Diabetes and Metabolism
Vascular damage Radboud Institute for Health Sciences [Radboudumc 16]
Vasomotion
Vasodilation
030204 cardiovascular system & hematology
Growth hormone
lcsh:Diseases of the endocrine glands. Clinical endocrinology
law.invention
03 medical and health sciences
0302 clinical medicine
Insulin resistance
Endocrinology
Randomized controlled trial
SDG 3 - Good Health and Well-being
law
Internal medicine
insulin resistance
medicine
vasomotion
Body Fat Distribution
Humans
030212 general & internal medicine
Insulin-Like Growth Factor I
Original Research
lcsh:RC648-665
Dose-Response Relationship
Drug
business.industry
Human Growth Hormone
Microcirculation
growth hormone treatment
Middle Aged
medicine.disease
Circumference
Growth hormone treatment
insulin-like growth factor-1
growth hormone
Body Composition
Female
Waist Circumference
growth hormone deficiency in adults
business
vascular endothelium
Zdroj: Frontiers in Endocrinology
Frontiers in endocrinology, 11:619173. Frontiers Media S.A.
Frontiers in Endocrinology, 11:619173. Frontiers Media S.A.
Frontiers in Endocrinology, 11
van Bunderen, C C, Meijer, R I, Lips, P, Kramer, M H, Serné, E H & Drent, M L 2021, ' Titrating Growth Hormone Dose to High-Normal IGF-1 Levels Has Beneficial Effects on Body Fat Distribution and Microcirculatory Function Despite Causing Insulin Resistance ', Frontiers in endocrinology, vol. 11, 619173 . https://doi.org/10.3389/fendo.2020.619173
van Bunderen, C C, Meijer, R I, Lips, P, Kramer, M H, Serne, E H & Drent, M L 2021, ' Titrating growth hormone dose to high-normal IGF-1 levels has beneficial effects on body fat distribution and microcirculatory function despite causing insulin resistance ', Frontiers in Endocrinology, vol. 11, 619173 . https://doi.org/10.3389/fendo.2020.619173, https://doi.org/10.3389/fendo.2020.619173
Frontiers in Endocrinology, Vol 11 (2021)
ISSN: 1664-2392
Popis: Contains fulltext : 232846.pdf (Publisher’s version ) (Open Access) To clarify the mechanism underlying the described U-shaped relation of both low and high levels of IGF-1 with cardiovascular disease this study explores the effect of decreasing and increasing growth hormone dose in GH deficient adults on (micro)vascular function, body composition and insulin resistance. In this randomized clinical trial, thirty-two subjects receiving GH therapy with an IGF-1 concentration between -1 and 1 SD score (SDS) for at least one year were randomized to receive either a decrease (IGF-1 target level of -2 to -1 SDS) or an increase of their daily GH dose (IGF-1 target level of 1 to 2 SDS) for a period of 24 weeks. Microvascular endothelium (in)dependent vasodilatation and vasomotion, vascular stiffness by pulse wave analysis, and HOMA-IR were measured. At the end of the study 30 subjects (65.6% men, mean age 46.6 (SD 9.9) years) were analyzed. There was a favorable effect of increasing the IGF-1 level on waist circumference compared to decreasing the IGF-1 level (p=0.05), but a detrimental effect on insulin resistance (p=0.03). Decreasing IGF-1 level significantly lowered the endothelial domain of vasomotion (p=0.03), whereas increasing IGF-1 level increased the contribution of the neurogenic domain (p=0.05). This change was related to the favorable change in waist circumference. In conclusion, increasing IGF-1 levels was beneficial for body composition but detrimental with respect to insulin resistance. The contribution of the neurogenic vasomotion domain increased in parallel, and could be explained by the favorable change in waist circumference. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, identifier NCT01877512.
Databáze: OpenAIRE
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