Occurrence of impaired fasting glucose in GH-deficient adults receiving GH replacement compared with untreated subjects.
OBJECTIVE
The effects of GH replacement on glucose metabolism in GH-deficient (GHD) adults in clinical practice are not well defined. Therefore, we assessed GH treatment effects on fasting plasma glucose (FPG) and haemoglobin A1c (A1c) concentrations in GHD adults in a clinical setting.


METHODS
Post-hoc analysis of the observational Hypopituitary Control and Complications Study conducted at 157 US centres (1997-2002).


METHODS
GH-deficient adults who were GH-naïve at study entry and had at least two FPG measurements.


METHODS
Effect of GH treatment on the frequency and time course of abnormal FPG (> or =5.6 mmol/l) development, FPG normalization, progression of increased FPG and abnormal follow-up A1c (>6%) values in GHD patients treated with GH (n = 403) or untreated (n = 169) at their physician's discretion.


RESULTS
In subjects without pre-existing diabetes mellitus, development of an abnormal FPG tended to occur in a greater percentage of GH-treated than untreated subjects (35.3% versus 24.5, P = 0.06). Additionally, GH treatment was associated with a mild, transient increase in FPG and shorter time to development of an abnormal FPG in these subjects (P < 0.01). Most ( approximately 80%) abnormal FPG values were below 7 mmol/l and normalized in 69% of GH-treated subjects without diabetes. Treatment with GH had no effect on the rate of FPG normalization, progression of increased FPG or abnormal follow-up A1c values.


CONCLUSIONS
Initiation of GH replacement in GHD adults was associated with a mild increase in FPG that often normalized spontaneously. Nevertheless, clinicians should monitor FPG in patients receiving GH treatment.
Lilly USA, Indianapolis, IN, USA.
Whitney W
WW
Woodmansee
Mark L
ML
Hartman
Steven W J
SW
Lamberts
Anthony J
AJ
Zagar
David R
DR
Clemmons
D000328:Adult; D000465:Algorithms; D001786:Blood Glucose / Q000378:metabolism; D048909:Diabetes Complications / Q000097:blood / Q000188:drug therapy / Q000378:metabolism; D005215:Fasting / Q000097:blood / Q000378:metabolism; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000453:epidemiology*; D006442:Glycated Hemoglobin / Q000032:analysis; D006130:Growth Disorders / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology* / Q000378:metabolism; D020249:Hormone Replacement Therapy / Q000009:adverse effects / Q000706:statistics & numerical data; D019382:Human Growth Hormone / Q000009:adverse effects / Q000172:deficiency / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D013997:Time Factors
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D019382:Human Growth Hormone; C517652:hemoglobin A1c protein, human