title: Glucose homeostasis in adults with Prader-Willi syndrome during treatment with growth hormone: results from a 12-month prospective study.
abstract: OBJECTIVE
  To investigate glucose homeostasis in relation to body mass index (BMI) in adults with PWS before and after GH therapy.
  
  
  METHODS
  We prospectively investigated the effects of a 12-month GH treatment on body composition and glucose homeostasis in relation to BMI in 39 adults, mean (±SD) age=28.6 (6.5) years with genetically verified PWS. We compared the results for different BMI categories (<25 kg/m²; 25-30 kg/m²; >30 kg/m²) and performed a regression analysis to detect predictors for homeostasis model of assessment-insulin resistance (HOMA-IR).
  
  
  RESULTS
  The baseline HOMA-IR was higher, with BMI of >30 kg/m². Our main findings were as follows: i) GH treatment (mean final dose, 0.6 (0.25) mg) was associated with small increases in fasting p-glucose, 2-h p-glucose by oral glucose load tolerance test, HOMA-IR and lean mass, and a reduction in fat mass. ii) Whereas the baseline HOMA-IR was associated with increased BMI (>30 kg/m²), we found no differences in HOMA-IR among the BMI categories after 12 months of GH. iii) Stepwise linear regression identified the triglyceride level as the strongest predictor of HOMA-IR at baseline, whereas an increase in VAT was the strongest predictor of the increase in HOMA-IR after therapy.
  
  
  CONCLUSIONS
  GH treatment for 12 months in adults with PWS resulted in an increase in HOMA-IR, irrespective of BMI, confirming that control of HbA1c is essential during GH treatment in PWS.
authors.affiliation: Section of Specialized Endocrinology, Department of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Norway. Electronic address: andjoe@ous-hf.no.
authors.forename: Anders Palmstrøm
authors.initials: AP
authors.lastname: Jørgensen
authors.affiliation: Research Institute for Internal Medicine, Faculty of Medicine, University of Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Thor
authors.initials: T
authors.lastname: Ueland
authors.affiliation: Centre for Rare Diseases, Department of Pediatrics, Aarhus University Hospital Skejby, Aarhus N, Denmark.
authors.forename: Rasmus
authors.initials: R
authors.lastname: Sode-Carlsen
authors.affiliation: Section of Specialized Endocrinology, Department of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: Thomas
authors.initials: T
authors.lastname: Schreiner
authors.affiliation: Frambu, Siggerud, Norway.
authors.forename: Kai Fredrik
authors.initials: KF
authors.lastname: Rabben
authors.affiliation: Centre for Rare Diseases, Department of Pediatrics, Aarhus University Hospital Skejby, Aarhus N, Denmark.
authors.forename: Stense
authors.initials: S
authors.lastname: Farholt
authors.affiliation: Department of Endocrinology, Metabolism and Diabetology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Høybye
authors.affiliation: Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus C, Denmark.
authors.forename: Jens Sandahl
authors.initials: JS
authors.lastname: Christiansen
authors.affiliation: Section of Specialized Endocrinology, Department of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Jens
authors.initials: J
authors.lastname: Bollerslev
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D015992:Body Mass Index; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005947:Glucose / Q000378:metabolism*; D006706:Homeostasis / Q000502:physiology*; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D007333:Insulin Resistance; D007334:Insulin-Like Growth Factor I / Q000494:pharmacology; D008297:Male; D011218:Prader-Willi Syndrome / Q000188:drug therapy* / Q000378:metabolism; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D015415:Biomarkers; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D005947:Glucose
keywords: Diabetes; Glucose; Growth hormone; Homeostasis model of assessment-insulin resistance; Insulin; Prader–Willi syndrome