Insulin sensitivity in adults with growth hormone deficiency and effect of growth hormone treatment.
Adult growth hormone deficiency (GHD) is a multifactorial disorder in which pituitary dysfunction associated with pituitary adenomas or their treatment plays a major role. The introduction of recombinant growth hormone (GH) for the treatment of GHD has opened up new treatment avenues but has also raised concerns about possible untoward long-term metabolic effects of GH, such as the potential effect of GH on insulin sensitivity and a deterioration in glucose tolerance. Research has shown that GH induces insulin resistance by the stimulation of lipolysis and a concomitant switch from oxidation of glucose to oxidation of lipids, during both acute and chronic treatment. However, although this is a consistent effect of GH therapy, it does not mean per se that it leads to abnormal glucose tolerance and diabetes mellitus. This article discusses this and other potential long-term metabolic effects of GH, and raises a number of questions to be addressed by future research.
Groop
Leif
L
Department of Endocrinology, Malmö University Hospital, Lund University, Malmö, Sweden. Leif.Groop@med.lu.se
Segerlantz
Mikael
M
Bramnert
Margareta
M
D000236:Adenoma / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D000328:Adult; D003920:Diabetes Mellitus / Q000139:chemically induced / Q000209:etiology / Q000378:metabolism; D005260:Female; D005947:Glucose / Q000378:metabolism; D018149:Glucose Intolerance / Q000139:chemically induced / Q000209:etiology / Q000378:metabolism; D019382:Human Growth Hormone / Q000009:adverse effects* / Q000172:deficiency* / Q000627:therapeutic use; D006801:Humans; D007333:Insulin Resistance; D050356:Lipid Metabolism / Q000187:drug effects*; D008297:Male; D010084:Oxidation-Reduction / Q000187:drug effects; D010911:Pituitary Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism
D019382:Human Growth Hormone; D005947:Glucose