TY - JOUR
T1 - Insulin sensitivity and β-cell function in adults with lifetime, untreated isolated growth hormone deficiency
AU - Oliveira, Carla R.P.
AU - Salvatori, Roberto
AU - Barreto-Filho, Jose A.S.
AU - Rocha, Ivina E.S.
AU - Mari, Andrea
AU - Pereira, Rossana M.C.
AU - Campos, Viviane C.
AU - Menezes, Menilsson
AU - Gomes, Elenilde
AU - Meneguz-Moreno, Rafael A.
AU - Araújo, Vanessa P.
AU - Leite, Natália T.F.
AU - Nascimento, Adão C.
AU - Farias, Maria I.T.
AU - Viscente, Thaisa A.R.
AU - Araújo, Raquel D.C.
AU - Melo, Enaldo V.
AU - Aguiar-Oliveira, Manuel H.
PY - 2012/3
Y1 - 2012/3
N2 - Context: GH reduces insulin sensitivity (IS), whereas IGF-I increases it. IGF-I seems to be critical for the development of the β-cells, and impaired IS has been reported in GH deficiency (GHD). Objective: The aim of the study was to assess IS and β-cell function in adult patients with untreated isolated GHD (IGHD) due to a homozygous mutation in the GHRH receptor gene. Design, Setting, and Patients: We conducted a cross-sectional study in 24 GH-naive adult IGHD subjects and 25 controls. Intervention:Weperformed an oral glucose tolerance test with glucose and insulin measurements at 0, 30, 60, 90, 120, and 180 min. Main Outcome Measures: IS was assessed by homeostasis model assessment index of insulin resistance (IR), quantitative IS check index, oral glucose IS in 2 h (OGIS2) and 3 h (OGIS3). β-Cell function was assayed by homeostasis model assessment index-β, insulinogenic index, and area under the curve of insulin-glucose ratio. Results: During theoral glucose tolerance test, glucose levels were higher in IGHD subjects (P<0.0001), whereas insulin response presented a trend toward reduction (P = 0.08). The number of individuals with impaired glucose tolerance was higher in the IGHD group (P=0.001), whereas the frequency of diabeteswassimilar in thetwogroups. Homeostasismodelassessment index of IRwaslower (P=0.04), and quantitative IS check index and OGIS2 showed a nonsignificant trend toward elevation (P=0.066 and P = 0.09, respectively) in IGHD. OGIS3 showed no difference between the groups. Homeostasis model assessment index-β, insulinogenic index, and ratio of the areas of the insulin and glucose curves were reduced in the IGDH group (P = 0.015, P < 0.0001, and P = 0.02, respectively). Conclusions: Adult subjects with lifetime congenital untreated IGHD present reduced β-cell function, no evidence of IR, and higher frequency of impaired glucose tolerance.
AB - Context: GH reduces insulin sensitivity (IS), whereas IGF-I increases it. IGF-I seems to be critical for the development of the β-cells, and impaired IS has been reported in GH deficiency (GHD). Objective: The aim of the study was to assess IS and β-cell function in adult patients with untreated isolated GHD (IGHD) due to a homozygous mutation in the GHRH receptor gene. Design, Setting, and Patients: We conducted a cross-sectional study in 24 GH-naive adult IGHD subjects and 25 controls. Intervention:Weperformed an oral glucose tolerance test with glucose and insulin measurements at 0, 30, 60, 90, 120, and 180 min. Main Outcome Measures: IS was assessed by homeostasis model assessment index of insulin resistance (IR), quantitative IS check index, oral glucose IS in 2 h (OGIS2) and 3 h (OGIS3). β-Cell function was assayed by homeostasis model assessment index-β, insulinogenic index, and area under the curve of insulin-glucose ratio. Results: During theoral glucose tolerance test, glucose levels were higher in IGHD subjects (P<0.0001), whereas insulin response presented a trend toward reduction (P = 0.08). The number of individuals with impaired glucose tolerance was higher in the IGHD group (P=0.001), whereas the frequency of diabeteswassimilar in thetwogroups. Homeostasismodelassessment index of IRwaslower (P=0.04), and quantitative IS check index and OGIS2 showed a nonsignificant trend toward elevation (P=0.066 and P = 0.09, respectively) in IGHD. OGIS3 showed no difference between the groups. Homeostasis model assessment index-β, insulinogenic index, and ratio of the areas of the insulin and glucose curves were reduced in the IGDH group (P = 0.015, P < 0.0001, and P = 0.02, respectively). Conclusions: Adult subjects with lifetime congenital untreated IGHD present reduced β-cell function, no evidence of IR, and higher frequency of impaired glucose tolerance.
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U2 - 10.1210/jc.2011-2590
DO - 10.1210/jc.2011-2590
M3 - Article
C2 - 22170707
AN - SCOPUS:84858031213
VL - 97
SP - 1013
EP - 1019
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
SN - 0021-972X
IS - 3
ER -