title: Changes in insulin levels following 6-month treatment with recombinant human growth hormone in growth hormone-deficient adults.
abstract: BACKGROUND
  Eighty-six adult patients with GH deficiency (GHD) of adult or childhood onset were treated for 6 months, with recombinant human growth hormone (rhGH) at a low (LD) or conventional dose (CD). The treatment effect on insulin levels was investigated.
  
  
  METHODS
  This manuscript refers to the Italian addendum to an International Study (B9R-EW-GDED) in which patients with GHD were randomized to receive r-hGH replacement therapy at a dose of either 3 microg/kg/day or 6 microg/kg/day for the 3 months. The dose was then doubled for the next 3 months.
  
  
  RESULTS
  After 6 months of r-hGH treatment, insulin levels increased with both GH dosages, with a greater increase achieved in the low-dose subgroup. Insulin levels also increased significantly in the childhood-onset, while even decreased in the adult-onset subgroup. On the whole, in more than 50% of patients, insulin values rose by >13%. Moreover, mean levels of IGF-I increased 2-3 fold (p<0.001 vs baseline) in both the LD and CD groups. Significant and similar increases in IGF binding protein-3 levels were seen in both the LD and CD groups over the treatment period, regardless the time of onset of GHD.
  
  
  CONCLUSIONS
  Insulin increased with both GH dosages and more than half of patients presented an important increase in insulin plasma levels. It would be of interest to assess if there is a correlation between the changes in insulin levels and other cardiovascular risk factors such as hemostatic parameters.
authors.affiliation: Medical Department, Eli Lilly Italia, Sesto Fiorentino, Florence, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Valle
authors.forename: M N D
authors.initials: MN
authors.lastname: Di Minno
authors.forename: V
authors.initials: V
authors.lastname: Palmieri
authors.forename: S
authors.initials: S
authors.lastname: Pezzullo
authors.forename: F
authors.initials: F
authors.lastname: Cirillo
authors.forename: C
authors.initials: C
authors.lastname: Di Somma
authors.forename: G
authors.initials: G
authors.lastname: Di Minno
authors.forename: G
authors.initials: G
authors.lastname: Lombardi
mesh_terms: D000328:Adult; D005260:Female; D019382:Human Growth Hormone / Q000008:administration & dosage / Q000172:deficiency* / Q000627:therapeutic use*; D006801:Humans; D007328:Insulin / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D011994:Recombinant Proteins / Q000627:therapeutic use
chemical_list: D007328:Insulin; D011994:Recombinant Proteins; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I