Effect of long‐term growth hormone treatment on carbohydrate metabolism in children with growth hormone deficiency

Seminara, Salvatore; Merello, G; Masi, Sara De; Filpo, A.; Cauza, F. La; D'Onghia, G.; Martelli, Elena; Loche, Sandro

doi:10.1046/j.1365-2265.1998.00502.x

Cited by 31 publications

(18 citation statements)

References 17 publications

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“…In our patient, after the first 4 weeks of rhGH treatment, a transient increase of blood glucose levels with elevation of HbA 1c was observed which had also been found in adults and children with GHD [21, 22]. However, with continuous administration of rhGH, visceral fat tissue was progressively decreased, and the insulin sensitivity improved.…”

Section: Discussionmentioning

confidence: 82%

Metabolic Effects of Growth Hormone Therapy in an Alström Syndrome Patient

Tai¹,

Lin²,

Sheu³

2003

Horm Res Paediatr

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Aim: To investigate the metabolic effects of recombinant human growth hormone (rhGH) in an Alström syndrome patient with growth hormone deficiency. Methods: A 15-year-old Alström syndrome boy with growth hormone deficiency received rhGH therapy for 1 year. Biochemical parameters, including hepatic enzyme levels, lipid profiles, and insulin sensitivity, were measured. Body composition analysis and computed tomography scans of the liver were performed. Results: After 1 year of rhGH treatment, body fat mass, fat infiltration in the liver, and serum lipid profiles had all decreased. Insulin sensitivity and acanthosis nigricans improved. Conclusion: rhGH therapy might have beneficial effects on body composition, liver fat content, lipid profiles, and insulin resistance in Alström syndrome patients, with improvement of the glucose homeostasis.

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Section: Discussionmentioning

confidence: 82%

Metabolic Effects of Growth Hormone Therapy in an Alström Syndrome Patient

Tai¹,

Lin²,

Sheu³

2003

Horm Res Paediatr

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“…GH transgenic animals have increased serum IGF-I levels, and GH administration to GH-deficient children or adults leads to increases in IGF-I concentrations (10,11,30). Several studies have supported the concept that these increases in IGF-I that occur in acromegaly may counteract part of the antiinsulin actions of GH itself.…”

Section: Discussionmentioning

confidence: 92%

“…At 20 min, 0.1 U/kg insulin was injected iv. After glucose administration, blood was collected at 1, 2, 3, 4, 5, 6,7,8,10,12,14,16,20,22,23,24,25,27,30,40,50, 60, 70, 80, 90, 100, 120, 160, and 180 min for glucose and insulin measurements. The data were analyzed by minimum model analysis using the computer program MINMOD to determine the insulin sensitivity index.…”

Section: Methodsmentioning

confidence: 99%

“…It has generally been assumed that GH acting through its receptor leads to insulin antagonism (8,9). This conclusion is based primarily on the results of animal studies, although administration of GH to GH-deficient children and adults clearly leads to blunted insulin sensitivity (10,11). Whether these effects are actually mediated through the GH receptor (GHR) in acromegaly has not been definitively determined.…”

mentioning

confidence: 97%

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IGF-I/IGF-Binding Protein-3 Combination Improves Insulin Resistance By GH-Dependent and Independent Mechanisms

O’Connell

Clemmons

2002

The Journal of Clinical Endocrinology & Metabolism

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IGF-I has been shown to enhance insulin sensitivity in patients with type I and type II diabetes. IGF-I suppresses GH, and this raises the question of whether its ability to enhance insulin sensitivity is mediated solely through a reduction in GH's antiinsulin actions. This study was conducted to determine whether administration of a GH receptor antagonist to patients with acromegaly and insulin resistance would result in improvement in insulin sensitivity and whether IGF-I had any additional insulin-sensitizing effects over and above those induced by its ability to suppress GH secretion. Five patients with active acromegaly were treated for 2 wk with a GH receptor antagonist. The GH receptor antagonist was effective, as IGF-I fell 65%, and mean GH values rose 42%. Mean fasting insulin fell from 39 +/- 6 to 30 +/- 7 micro U/ml, and this was accompanied by a 9% decrease in fasting glucose. After treatment the insulin sensitivity index was 2.7 +/- 1.0 x 10(-4)/min. micro U/ml compared with a baseline value of 1.65 +/- 0.8 x 10(-4)/min. micro U/ml (P < 0.015). Subsequently, the subjects were treated with the receptor antagonist plus IGF-I/IGF-binding protein-3 given by sc injection (1 mg/kg daily). After 2 wk of the combined treatment, fasting insulin fell from 49 +/- 9 to 29 +/- 7 micro U/ml, and fasting glucose fell by 14%. The insulin sensitivity index improved to 4.34 +/- 1.3 x 10(-4)/min. micro U/ml, which was significantly greater than the value obtained after treatment with the GH antagonist alone. Although only a limited number of subjects were studied, the results strongly suggest that IGF-I has insulin-sensitizing actions that are independent of its ability to suppress GH secretion. These findings necessitate further studies into the non-GH-related mechanism by which IGF-I enhances insulin sensitivity.

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“…Two patients reported AEs related to glucose intolerance that were considered related to GH. Growth hormone may decrease insulin sensitivity, particularly at higher doses in susceptible patients, leading to unmasking of previously undiagnosed impaired glucose tolerance and overt diabetes mellitus [19,20,24,25]. The observational study design of GeNeSIS allowed evaluation of GH in real-world clinical practice.…”

Section: Fig 5 Treatment Effect Of Gh Over 4 Years On Igf-i Sds In Tmentioning

confidence: 99%

An observational study of the effectiveness and safety of growth hormone (Humatrope<sup>®</sup>) treatment in Japanese children with growth hormone deficiency or Turner syndrome

et al. 2013

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Effect of long‐term growth hormone treatment on carbohydrate metabolism in children with growth hormone deficiency

Abstract: Our data show that long-term GH treatment in GH deficient children causes hyperglycaemia and increased insulin secretion. These effects may in some patients induce glucose intolerance, which is reversible with appropriate dietary measures and does not require discontinuation of treatment.

Cited by 31 publications

References 17 publications

Metabolic Effects of Growth Hormone Therapy in an Alström Syndrome Patient

Metabolic Effects of Growth Hormone Therapy in an Alström Syndrome Patient

IGF-I/IGF-Binding Protein-3 Combination Improves Insulin Resistance By GH-Dependent and Independent Mechanisms

An observational study of the effectiveness and safety of growth hormone (Humatrope<sup>®</sup>) treatment in Japanese children with growth hormone deficiency or Turner syndrome

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