Insulin sensitivity in growth hormone-deficient children: influence of replacement treatment.

Abstract:

OBJECTIVE:In adults, excessive GH secretion may lead to secondary diabetes mellitus, while prolonged GH treatment may accelerate the onset of type 2 diabetes mellitus in predisposed children. The aim of the study was to evaluate insulin sensitivity (IS) and glucose tolerance (GT) in a group of GH-deficient children treated with GH for a period of 6 years. PATIENTS AND DESIGN:One hundred and twenty-eight children (40 females, 88 males) were included in the study. At the beginning of treatment chronological age was 8.9 +/- 3.2 years, height standard deviation score (SDS) -2.43 +/- 0.90 and body mass index (BMI) SDS 0.18 +/- 1.60. At the end of the study chronological age was 13.0 +/- 2.9 years, height SDS -1.24 +/- 1.27 and BMI SDS 0.23 +/- 1.54. GH was administered at a mean weekly dosage of 0.3 mg/kg, injected subcutaneously over 6-7 days. GT was assessed according to the criteria of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. IS was evaluated with the quantitative insulin sensitivity check index (QUICKI). RESULTS:No cases of impaired GT or diabetes were recorded during the follow-up period. IS, already lower than in controls before starting treatment with GH, decreased significantly during the first year of therapy (QUICKI: 0.346 +/- 0.033 vs. 0.355 +/- 0.044, P < 0.05), with no further decrease in the following years. No correlation was found between QUICKI, BMI, years of treatment and onset of puberty. CONCLUSIONS:GH treatment in GH-deficient children does not lead to an impaired GT or type 2 diabetes mellitus, although it does significantly decrease IS.

journal_name

Clin Endocrinol (Oxf)

journal_title

Clinical endocrinology

authors

Radetti G,Pasquino B,Gottardi E,Contadin IB,Rigon F,Aimaretti G

doi

10.1111/j.1365-2265.2004.02113.x

keywords:

subject

Has Abstract

pub_date

2004-10-01 00:00:00

pages

473-7

issue

4

eissn

0300-0664

issn

1365-2265

pii

CEN2113

journal_volume

61

pub_type

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