Long-term effects of recombinant human insulin-like growth factor I treatment on glucose and lipid metabolism and the growth of a patient with congenital generalized lipodystrophy.
Congenital generalized lipodystrophy (CGL) is a disease characterized by generalized lack of body fat, insulin resistance, hypertriglyceridemia, and fatty liver. We studied the long-term effects of recombinant human insulin-like growth factor I (rhIGF-I) treatment on glucose and lipid metabolism and the growth in a patient with CGL. During rhIGF-I treatment, the serum triglyceride level was maintained almost within the normal range, and the plasma glycosylated hemoglobin A1c (HbA1c) levels were maintained under 8.0% (5.8%-7.9%). Thus, rhIGF-I treatment was effective in lowering glucose and triglyceride levels over the long-term in a CGL patient. However, it was difficult to suppress the patient's voracious appetite. Although serum total IGF-I levels were extremely high (1000-1700 ng/ml), growth was not accelerated after the start of rhIGF-I treatment, likely because of normal IGF binding protein 3 (IGFBP-3) levels. During rhIGF-I treatment, the patient developed a recurrence of mild hypertrophic cardiomyopathy and a mild elevation of intraocular pressure.
Satoh
Mari
M
First Department of Pediatrics, Toho University School of medicine, Oomorinishi, Tokyo, Japan.
Yoshizawa
Atsuko
A
Takesue
Masarou
M
Saji
Tsutomu
T
Yokoya
Susumu
S
D000293:Adolescent; D001798:Blood Proteins / Q000032:analysis; D005260:Female; D005947:Glucose / Q000378:metabolism*; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D048788:Growth and Development / Q000187:drug effects*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000009:adverse effects / Q000032:analysis / Q000627:therapeutic use*; D050356:Lipid Metabolism / Q000187:drug effects*; D052497:Lipodystrophy, Congenital Generalized / Q000188:drug therapy*; D011994:Recombinant Proteins / Q000627:therapeutic use; D013995:Time
D001798:Blood Proteins; D005947:Glucose; D006442:Glycated Hemoglobin; D007334:Insulin-Like Growth Factor I; D011994:Recombinant Proteins