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 |
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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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