Effects of growth hormone releasing hormone on insulin action and insulin secretion in a hypopituitary patient evaluated by the clamp technique.
The effect of growth hormone releasing hormone (GHRH-44) therapy on insulin action and secretion was evaluated in a hypopituitary patient after one month and one year of treatment. Hepatic and peripheral insulin action was studied with the hyperinsulinemic-euglycemic clamp in combination with [6,6-2H2]glucose tracer infusion. First and second phase insulin secretion was assessed with the hyperglycemic clamp. Prior to GHRH-44 therapy the hypopituitary patient had higher insulin mediated glucose disposal rate and lower basal and stimulated insulin concentrations by more than two standard deviations from the mean of a control group. Following therapy there was no change in basal hepatic glucose production; however, there was evidence of diminished peripheral insulin action. This was manifested by decreased insulin mediated glucose disposal during the hyperinsulinemic-euglycemic clamp, and increased insulin secretion during the hyperglycemic clamp. We conclude that GHRH-44 therapy in this patient was associated with decreased peripheral insulin action which was compensated for by increased insulin secretion.
Arslanian
S
S
Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus, Children's Hospital, University of Pittsburgh, PA 15213.
Kalhan
S
S
D002648:Child; D005260:Female; D015309:Glucose Clamp Technique; D013007:Growth Hormone-Releasing Hormone / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D007018:Hypopituitarism / Q000097:blood* / Q000188:drug therapy / Q000503:physiopathology*; D007328:Insulin / Q000097:blood* / Q000502:physiology*; D013997:Time Factors
D007328:Insulin; D013007:Growth Hormone-Releasing Hormone