[Insulin binding to erythrocytes in chronic glucocorticoid deficiency--investigation before and during replacement...

The effect of chronic glucocorticoid deficiency on insulin binding to erythrocyte was evaluated in 2 cases of ACTH deficiency, 2 of Sheehan's syndrome and a case of Addison's disease before and after the replacement therapy with cortisone acetate. 75 gram oral glucose tolerance test (OGTT) was also performed. Mean fasting plasma glucose (FPG) and insulin (FIRI) before (70.2 mg/dl, 3.6 microU/ml) and after (75.4 mg/dl, 7.8 microU/ml) therapy were significantly lower than those in normal control (97.0 mg/dl, 12.0 microU/ml). The ratio of FIRI/FPG before and after treatment were also significantly lower than that in control subjects. Glucose areas during OGTT before and after treatment were not different from that in control subjects. However, insulin area before treatment was significantly lower than that in control group. There were significant increases in FIRI/FPG and insulin area, but not in FPG and glucose area before and after treatment. Insulin binding to erythrocytes before treatment (11.9 +/- 1.1%, mean +/- SD) was greater than that in normal subjects (7.7 +/- 1.9%, n = 19, p less than 0.05). It was significantly decreased and normalized to 7.8 +/- 2.0% by the treatment. Analysis of binding parameters revealed the increases in receptor concentration at high affinity site (R1) and in average affinity at empty site by average affinity profile (Ke) before treatment in comparison with control subjects. There was no significant difference in binding parameters after treatment and in control group. High R1 or low R2 observed before treatment was significantly decreased or increased after treatment, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)