Insulin sensitivity and β-cell function in adults with lifetime, untreated isolated growth hormone deficiency

Carla R.P. Oliveira, Roberto Salvatori, Jose A.S. Barreto-Filho, Ivina E.S. Rocha, Andrea Mari, Rossana M.C. Pereira, Viviane C. Campos, Menilsson Menezes, Elenilde Gomes, Rafael A. Meneguz-Moreno, Vanessa P. Araújo, Natália T.F. Leite, Adão C. Nascimento, Maria I.T. Farias, Thaisa A.R. Viscente, Raquel D.C. Araújo, Enaldo V. Melo, Manuel H. Aguiar-Oliveira

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1013-1019
Number of pages7
JournalJournal of Clinical Endocrinology and Metabolism
Volume97
Issue number3
DOIs
StatePublished - Mar 2012

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

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