Differential effects of prednisone and growth hormone on fuel metabolism and insulin antagonism in humans.
Human growth hormone (hGH) and prednisone cause insulin resistance and glucose intolerance. However, it is unknown whether hGH and prednisone antagonize insulin action on protein, fat, and carbohydrate metabolism by a common or independent mechanism. Therefore, protein, fat, and carbohydrate metabolism was assessed simultaneously in four groups of eight subjects each after 7 days of placebo, recombinant DNA hGH (rhGH; 0.1 mg.kg-1.day-1), prednisone (0.8 mg.kg-1.day-1), or rhGH and prednisone administration after an 18-h fast and during gut infusion of glucose and amino acids (fed state). Fasting plasma glucose concentrations were similar during placebo and rhGH but elevated (P less than 0.001) during combined treatment, whereas plasma insulin concentrations were higher (237 +/- 57 pmol/ml, P less than 0.001) during combined than during placebo, rhGH, or prednisone treatment (34, 52, and 91 pM, respectively). In the fed state, plasma glucose concentrations were elevated only during combined treatment (11.3 +/- 2.1 mM, P less than 0.001). Plasma insulin concentrations were elevated during therapy with prednisone alone and rhGH alone (667 +/- 72 and 564 +/- 65 pmol/ml, respectively, P less than 0.001) compared with placebo (226 +/- 44 pmol/ml) but lower than with the combined rhGH and prednisone treatment (1249 +/- 54 pmol/ml, P less than 0.01). Protein oxidation [( 14C]leucine) increased (P less than 0.001) with prednisone therapy, decreased (P less than 0.001) with rhGH treatment, and was normal during the combined treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
Horber
F F
FF
Department of Pediatrics, Mayo Clinic, Rochester, Minnesota.
Marsh
H M
HM
Haymond
M W
MW
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002151:Calorimetry; D002250:Carbon Radioisotopes; D003903:Deuterium; D004734:Energy Metabolism / Q000187:drug effects*; D005215:Fasting; D005947:Glucose / Q000378:metabolism*; D013006:Growth Hormone / Q000494:pharmacology*; D006801:Humans; D007328:Insulin / Q000097:blood / Q000502:physiology*; D007329:Insulin Antagonists; D007651:Keto Acids / Q000097:blood; D011241:Prednisone / Q000494:pharmacology*; D011506:Proteins / Q000378:metabolism; D011865:Radioisotope Dilution Technique; D011994:Recombinant Proteins / Q000494:pharmacology; D012016:Reference Values
D001786:Blood Glucose; D002250:Carbon Radioisotopes; D007328:Insulin; D007329:Insulin Antagonists; D007651:Keto Acids; D011506:Proteins; D011994:Recombinant Proteins; C013082:alpha-ketoisocaproic acid; D013006:Growth Hormone; D003903:Deuterium; D005947:Glucose; D011241:Prednisone