Glucose metabolism and visceral fat in GH deficient adults: 1 year of GH replacement.
The aim of the current study is to evaluate the effects of 12-month growth hormone (GH) replacement on glucose metabolism and visceral fat in 24 adults with GH deficiency (11 men, 13 women, age 41+/-1.9 year, BMI 27+/-1.2 kg/m2. Glucose metabolism was measured in the fasting state by the homeostatic model assessment (HOMA) insulin resistance index and during a standard oral glucose tolerance test (OGTT). Data were analyzed by HOMA and the insulin sensitivity index (ISI)-composite derived from the OGTT. Visceral fat was evaluated by CT scan. GH-deficient adults had increased visceral fat (P=0.029) with lower fasting glucose levels (P=0.004) than the control group on baseline evaluation. GH replacement induced deterioration in glucose metabolism, with progressive increment in fasting insulin levels at 6 and 12 months (P=0.024) and in 2-h-OGTT insulin levels at 3, 6 and 12 months (P=0.001). Plasma glucose levels did not change during the study. There was a deterioration in insulin sensitivity index observed by an increase in HOMA-IR (P=0.049) and a reduction in the ISI-composite (P=0.028), both at 12 months of replacement. Visceral fat and waist-to-hip-ratio (WHR) reduced not only at month 6 but also at month 12 (P=0.0001 and 0.023, respectively). In conclusion, 12 months of GH replacement seem to impair glucose homeostasis, despite favorable alterations in body composition.
Spina
Luciana Diniz Carneiro
LD
Endocrine Service of Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro-UFRJ, Rio de Janeiro, RJ, Brazil. luspina@openlink.com.br
Soares
Débora Vieira
DV
Brasil
Rosane R L O
RR
da Silva
Eliana M C
EM
Lobo
Priscila M
PM
Conceição
Flávia Lucia
FL
Vaisman
Mário
M
D000273:Adipose Tissue / Q000187:drug effects* / Q000378:metabolism; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D001823:Body Composition / Q000187:drug effects; D005215:Fasting; D005260:Female; D005947:Glucose / Q000378:metabolism*; D013006:Growth Hormone / Q000172:deficiency* / Q000627:therapeutic use*; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D014781:Viscera / Q000187:drug effects
D001786:Blood Glucose; D007328:Insulin; D013006:Growth Hormone; D005947:Glucose