title: Glucose metabolism and visceral fat in GH deficient adults: two years of GH-replacement.
abstract: The aim of this study was to evaluate the effect of 24 months of growth hormone (GH) replacement on glucose metabolism and visceral fat in 17 adults with GH deficiency: 9 men and 8 women; age 40 +/- 1.8 yr. [range 20-61] and body mass index 25 +/- 0.8 Kg/m2. Glucose metabolism was evaluated by a standard oral glucose tolerance test (OGTT), by the homeostatic model assessment (HOMA) insulin resistance index and by the insulin sensitivity index (ISI)-composite derived from the OGTT. Visceral fat was evaluated by CT scan.Twenty-four months of GH replacement induced an increase in the prevalence of abnormal glucose tolerance, with significant progressive increment in 2h-OGTT insulin levels at 3, 12 and 24 months (p = 0.005). Plasma glucose levels and ISI-composite did not alter during the study. HOMA-IR index increased only in the group of patients (n = 8) who had abnormal OGTT at 24 months (p = 0.012). Visceral fat reduced at month 12 and remained decreased until the end of the study (p = 0.009). In conclusion, the present study suggests that adults with GH deficiency after twenty-four months of GH replacement developed abnormal glucose tolerance, probably due to an increase in insulin resistance, associated with higher insulin levels, despite favorable alterations in body composition.
authors.affiliation: Serviço de Endocrinologia do Hospital Universitário Clementino Fraga Filho, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil. lucianaspina@terra.com.br.|Rua José Linhares, 244/ 05, Leblon, Cep 22430-220, Rio de Janeiro, RJ, Brasil. lucianaspina@terra.com.br.
authors.forename: Luciana Diniz Carneiro
authors.initials: LD
authors.lastname: Spina
authors.affiliation: Serviço de Endocrinologia do Hospital Universitário Clementino Fraga Filho, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil.
authors.forename: Débora Vieira
authors.initials: DV
authors.lastname: Soares
authors.affiliation: Serviço de Endocrinologia do Hospital Universitário Clementino Fraga Filho, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil.
authors.forename: Rosane Resende de Lima Oliveira
authors.initials: RR
authors.lastname: Brasil
authors.affiliation: Serviço de Endocrinologia do Hospital Universitário Clementino Fraga Filho, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil.
authors.forename: Priscila Marise
authors.initials: PM
authors.lastname: Lobo
authors.affiliation: Serviço de Endocrinologia do Hospital Universitário Clementino Fraga Filho, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil.
authors.forename: Flávia
authors.initials: F
authors.lastname: Lúcia Conceição
authors.affiliation: Serviço de Endocrinologia do Hospital Universitário Clementino Fraga Filho, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil.
authors.forename: Mário
authors.initials: M
authors.lastname: Vaisman
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition; D015992:Body Mass Index; D005260:Female; D005947:Glucose / Q000378:metabolism*; D018149:Glucose Intolerance; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000172:deficiency* / Q000627:therapeutic use*; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D050152:Intra-Abdominal Fat; D008297:Male; D008875:Middle Aged; D010900:Pituitary Diseases / Q000188:drug therapy* / Q000378:metabolism; D011994:Recombinant Proteins / Q000627:therapeutic use; D012680:Sensitivity and Specificity; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D007328:Insulin; D011994:Recombinant Proteins; D019382:Human Growth Hormone; D005947:Glucose