Effects of morning cortisol replacement on glucose and lipid metabolism in GH-treated subjects
| Autor: | Esa Laurila, Ronnie Thomasson, Mikael Segerlantz, Per Manhem, Margareta Bramnert, Leif Groop |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty Cortisol awakening response Hydrocortisone Hormone Replacement Therapy Pituitary Diseases Endocrinology Diabetes and Metabolism Glucose uptake Fatty Acids Nonesterified Biology Placebo Endocrinology Insulin resistance Adrenocorticotropic Hormone Internal medicine medicine Humans Insulin Morning Human Growth Hormone Proteins Reproducibility of Results Calorimetry Indirect General Medicine Middle Aged medicine.disease Lipids Growth Hormone Glucose Clamp Technique Female Lipid Peroxidation Insulin Resistance Energy Metabolism Oxidation-Reduction Glucocorticoid medicine.drug Hormone |
| Zdroj: | European Journal of Endocrinology. :701-707 |
| ISSN: | 1479-683X 0804-4643 |
| DOI: | 10.1530/eje.0.1510701 |
| Popis: | OBJECTIVE: Insulin resistance is a frequent consequence of GH replacement therapy but patients on GH replacement therapy often also have replacement of other hormone deficiencies which theoretically could modify the metabolic effects of GH. In particular, cortisol replacement if given in supra physiologic doses immediately before the evaluation of insulin sensitivity could influence insulin sensitivity. The aim of this study was thus to evaluate the effect of morning cortisol replacement given prior to a euglycaemic clamp combined with infusion of [3-(3)H]glucose and indirect calorimetry on glucose and lipid metabolism. METHODS: Ten GH/ACTH-deficient adults received, in a double-blind manner, either cortisol (A) or placebo (B) before the clamp whereas five GH-deficient-ACTH-sufficient adults participated in a control (C) clamp experiment. All subjects received GH replacement therapy. RESULTS: Serum cortisol levels were significantly higher after cortisol than after placebo (324+/-156 vs 132+/-136 mmol/l; P=0.006) and similar to controls (177+/-104 mmol/l). As a measure of the biological effect of cortisol, eosinophil leukocyte counts in peripheral blood decreased (164+/-91x10(9)/l vs 216+/-94x10(9)/l; P=0.04). Cortisol replacement had no significant effect on insulin-stimulated glucose uptake (11.8+/-1.8 vs 13.2+/-3.9 mumol/kg min), either on glucose oxidation or on glucose storage. There was also no significant effect of cortisol on fasting endogenous glucose production and no effect was seen on serum free fatty acid concentrations. CONCLUSION: Administration of cortisol in the morning before a clamp cannot explain the insulin resistance seen with GH replacement therapy. |
| Databáze: | OpenAIRE |
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