Titre du document / Document title

Growth hormone-deficient adults are insulin-resistant

Auteur(s) / Author(s)

JOHANSSON J.-O. ; FOWELIN J. ; LANDIN K. ; LAGER I. ; BENTSSON B.-A. ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

Göteborg univ., sahlgrenska univ. hosp., dep. medicine, Göteborg, SUEDE

Résumé / Abstract

Patients with growth hormone deficiency (GHD) have traditionally been described as having increased insulin sensitivity with a tendency toward fasting hypoglycemia, at least in children. In other studies, impaired glucose tolerance has been found. To evaluate basal insulin sensitivity, a hyperinsulinemic, normoglycemic clamp was performed with an insulin infusion rate of 40 mU/m²/min after an overnight fast. Fifteen patients (four women and 11 men aged 20 to 62 years) with GHD for at least 1 year were compared with 15 healthy controls matched for sex, age, and body mass index (BMI). Thirteen patients had complete pituitary deficiency and were being treated with conventional hormone replacement therapy. Two men had isolated GHD since childhood. Four men were being treated with bromocriptin. There were no significant differences between fasting blood glucose (4.4 ± 0.1 v 4.7 ± 0.2 [mean ± SEM] mmol/L) or fasting plasma insulin (9.5 ± 1.4 v 8.8 ± 1.1 mU/L) in patients and controls, respectively. Fasting free fatty acid (FFA) levels were lower in patients (444 ± 35 v 796 ± 94 μmol/L, P <.01). Blood glucose levels during the clamp were similar (4.6 ± 0.1 v 4.9 ± 0.1 mmol/L), as were insulin levels (81 ± 4 v 93 ± 4 mU/L). A decrease in glucose infusion rate (GIR) was seen during the clamp in GHD subjects (3.9 ± 0.5 v 9.9 ± 0.7 mg/kg body weight/min) as compared with controls (P =.001). Even if corrections were made for body fat, there was a significant difference (GIR corrected per lean body mass, 5.8 ± 0.8 v 13.9 ± 0.9 mg/kg lean body mass/min, P <.001). The results suggest that adults with GHD are insulin-resistant. Despite this finding, normal fasting plasma insulin levels were seen.

Revue / Journal Title

Metabolism, clinical and experimental   ISSN 0026-0495 

Source / Source

1995, vol. 44, n^o9, pp. 1126-1129 (28 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, New York, NY, ETATS-UNIS  (1952) (Revue)

Mots-clés anglais / English Keywords

Deficiency ; STH ; Adult ; Target tissue resistance ; Insulin ; Association ; Human ; Adenohypophyseal hormone ; Protein hormone ; Pancreatic hormone ;

Mots-clés français / French Keywords

Déficit ; STH ; Adulte ; Résistance tissu cible ; Insuline ; Association ; Homme ; Hormone adénohypophysaire ; Hormone protéine ; Hormone pancréatique ;

Mots-clés espagnols / Spanish Keywords

Déficiencia ; STH ; Adulto ; Resistencia tejido blanco ; Insulina ; Asociación ; Hombre ; Hormona adenohipofisaria ; Hormona proteina ; Hormona pancreática ;

Localisation / Location

INIST-CNRS, Cote INIST : 6965, 35400005040770.0050