title: Glucose metabolism and visceral fat in GH deficient adults: 1 year of GH replacement.
abstract: 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.
authors.affiliation: Endocrine Service of Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro-UFRJ, Rio de Janeiro, RJ, Brazil. luspina@openlink.com.br
authors.forename: Luciana Diniz Carneiro
authors.initials: LD
authors.lastname: Spina
authors.forename: Débora Vieira
authors.initials: DV
authors.lastname: Soares
authors.forename: Rosane R L O
authors.initials: RR
authors.lastname: Brasil
authors.forename: Eliana M C
authors.initials: EM
authors.lastname: da Silva
authors.forename: Priscila M
authors.initials: PM
authors.lastname: Lobo
authors.forename: Flávia Lucia
authors.initials: FL
authors.lastname: Conceição
authors.forename: Mário
authors.initials: M
authors.lastname: Vaisman
mesh_terms: 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
chemical_list: D001786:Blood Glucose; D007328:Insulin; D013006:Growth Hormone; D005947:Glucose