Cordoba-Chacon J, Gahete MD, McGuinness OP, Kineman RD. Differential impact of selective GH deficiency and endogenous GH excess on insulin-mediated actions in muscle and liver of male mice. Am J Physiol Endocrinol Metab 307: E928 -E934, 2014. First published September 30, 2014; doi:10.1152/ajpendo.00420.2014.-A reciprocal relationship between insulin sensitivity and glucose tolerance has been reported in some mouse models and humans with isolated changes in growth hormone (GH) production and signaling. To determine if this could be explained in part by tissue-specific changes in insulin sensitivity, hyperinsulinemic-euglycemic clamps were performed in mice with adult-onset, isolated GH deficiency and in mice with elevated endogenous GH levels due to somatotropespecific loss of IGF-I and insulin receptors. Our results demonstrate that circulating GH levels are negatively correlated with insulinmediated glucose uptake in muscle but positively correlated with insulin-mediated suppression of hepatic glucose production. A positive relationship was also observed between GH levels and endpoints of hepatic lipid metabolism known to be regulated by insulin. These results suggest hepatic insulin resistance could represent an early metabolic defect in GH deficiency. growth hormone; hepatic glucose production; triglycerides; glucose disposal; hyperinsulinemic-euglycemic clamps HUMANS WITH LONG-TERM adult-onset growth hormone deficiency (AOGHD) have been reported to have impaired glucose tolerance (5, 27, 32), systemic insulin resistance, and increased hepatic glucose production [HGP;(12,16,24)], with a higher prevalence of diabetes (1). However, the direct impact of growth hormone deficiency (GHD) on insulin-mediated glucose homeostasis is not clear cut. AOGHD patients can show reduced (5), normal (12), or elevated (8) insulin levels. A wide spectrum of insulin sensitivity in AOGHD patients may be in part due to the length, severity, multiplicity, and etiology of pituitary deficiencies, leading to variable effects on body composition (1,9,14,30). In fact, insulin sensitivity was shown to be improved in AOGHD subjects compared with age-, sex-, and body mass index (BMI)-matched controls (28). Also, subjects with congenital isolated GHD resulting from an inactivating mutation in the growth hormone-releasing hormone (GHRH) receptor are more insulin sensitive compared with their unaffected relatives despite increased visceral adiposity and glucose intolerance (27,32). Glucose intolerance, with improved systemic insulin sensitivity [as measured by insulin tolerance tests (ITT)], is also observed in mouse models with GHD (7) and growth hormone (GH) resistance (11,13). Notably, the opposite metabolic phenotype (improved glucose tolerance with normal/reduced insulin sensitivity) is observed in mice with elevated heterologous (6) or endogenous (10) GH levels.The disconnect between systemic insulin sensitivity and glucose tolerance observed in mouse model systems and humans with isolated changes in GH production and signaling (6,7,10,...