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Insulin therapy increases low plasma growth hormone binding protein in children with new-onset type 1 diabetes
S A Arslanian1, R K Menon, A P Gierl
1Division of Pediatric Endocrinology, Metabolism and Diabetes Mellitus, Children's Hospital, University of Pittsburgh, PA.
Insights
Growth hormone binding protein (GHBP) is low in new Type 1 diabetes cases. Insulin therapy increases GHBP over three months, but levels remain below normal, indicating insulin
Area of Science:
- Endocrinology
- Metabolic Disorders
- Pediatric Diabetes Research
Background:
- Type 1 diabetes is characterized by metabolic dysregulation.
- Growth hormone binding protein (GHBP) plays a role in growth hormone homeostasis.
- The status of GHBP in newly diagnosed Type 1 diabetes and its response to therapy are not fully understood.
Purpose of the Study:
- To evaluate growth hormone binding protein (GHBP) levels in newly diagnosed Type 1 diabetes patients.
- To assess the changes in GHBP levels following initiation of insulin therapy.
- To determine the relationship between GHBP levels and glycemic control, C-peptide, and blood pH.
Main Methods:
- GHBP levels were measured in 33 newly diagnosed Type 1 diabetes patients.
- Measurements were taken before, after 5 days, and after 3 months of insulin therapy.
- GHBP was quantified using radioimmunoassay and correlated with clinical parameters.
Main Results:
- Baseline GHBP levels were significantly lower in Type 1 diabetes patients compared to healthy controls.
- GHBP levels showed no significant improvement after 5 days of insulin therapy.
- After 3 months of insulin therapy, GHBP levels increased but remained lower than in controls; initial GHBP correlated with BMI, blood glucose, and pH.
Conclusions:
- Circulating GHBP is reduced in newly diagnosed Type 1 diabetes.
- Insulin therapy increases GHBP levels over 3 months, though normalization is not achieved.
- Biochemical derangement severity and residual beta-cell function may influence GHBP status and recovery in Type 1 diabetes.
Abstract:
This study was undertaken (1) to evaluate growth hormone binding protein (GHBP) levels in newly diagnosed patients with Type 1 diabetes before and after insulin therapy and (2) to determine the relationship of GHBP to glycaemic control, C-peptide level and blood pH. GHBP, expressed as a percentage of (125I)GH bound, was determined in 33 patients with Type 1 diabetes (M/F = 19/14, 12.3 +/- 0.4 years) before (day 0), after 5 days (day 5) and after 3 months (month 3) of insulin therapy. At day 0, GHBP was lower in Type 1 diabetes compared with 38 matched healthy control subjects (3.9 +/- 0.4 vs 8.2 +/- 0.4%, p < 0.001). There was no significant improvement in GHBP at day 5 (4.4 +/- 0.3%). At month 3, GHBP increased to (6.0 +/- 0.4%, p < 0.001 vs day 0), but was still lower than controls, p < 0.001. At day 0 GHBP correlated with BMI (r = 0.50, p = 0.001), blood glucose (r = -0.43 p = 0.006) and pH (r = 0.48, p = 0.004), but not HbA1. GHBP at month 3 correlated with day 0 C-peptide (r = 0.41, p = 0.02). Thus, (1) circulating GHBP is low in newly diagnosed patients with Type 1 diabetes, and increases after 3 months of insulin therapy but does not normalize and (2) the severity of biochemical derangement and residual beta-cell function at diagnosis may determine GHBP status and its recovery. We conclude that insulin is an important modulator of GH binding protein in newly diagnosed children with Type 1 diabetes.