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Insulin antagonistic effects of growth hormone in short children
1Department of Pediatrics, University of Iowa College of Medicine, Iowa City, USA.
Insights
Growth hormone therapy in children can decrease insulin sensitivity (SI) over six months. This study tracked SI and glucose effectiveness (Sg) in children receiving growth hormone treatment.
Area of Science:
- Pediatric Endocrinology
- Metabolic Research
- Hormone Therapy
Background:
- Growth hormone (GH) exhibits insulin-antagonistic properties.
- Understanding the temporal effects of GH on insulin sensitivity is crucial for pediatric patients.
Purpose of the Study:
- To investigate the time course of insulin sensitivity (SI) and glucose effectiveness (Sg) during growth hormone therapy in children.
- To assess changes in cardiovascular risk factors associated with GH treatment.
Main Methods:
- Utilized the frequently sampled intravenous glucose tolerance test (FSIGT) to measure SI and Sg.
- Monitored 3 groups of children: growth hormone deficiency (GHD), non-growth-hormone-deficient short stature (NGHD), and Turner syndrome (TS).
- Measurements were taken before, and at 1 week, 1 month, and 6 months after initiating GH therapy.
Main Results:
- Pretreatment SI was significantly lower in Turner syndrome (TS) patients compared to GHD and NGHD groups.
- Insulin sensitivity (SI) decreased significantly after 6 months of GH therapy compared to baseline and 1-week follow-up.
- No significant changes were observed in glucose effectiveness (Sg), glucose tolerance, blood pressure, triglyceride, or cholesterol levels. Incremental insulin response increased.
Conclusions:
- Six months of growth hormone therapy in children led to a significant decrease in insulin sensitivity (SI).
- Growth hormone therapy did not appear to negatively impact other cardiovascular risk factors in this cohort.
- Further research with larger sample sizes is warranted to confirm these findings.
Abstract:
Growth hormone has several insulin antagonistic effects. To determine the time course of these effects in growth-hormone-treated children, the frequently samples intravenous glucose tolerance test was used to measure insulin sensitivity (SI) and glucose effectiveness (Sg) before, and 1 week, 1 month and 6 months after beginning growth hormone therapy in 3 patients with growth hormone deficiency (GHD), 3 patients with non-growth-hormone-deficient short stature (NGHD) and 3 with Turner syndrome (TS). Pretreatment SI was lower in TS than in the other two groups (p < 0.05), but Sg did not differ between groups. Mean SI levels 1 week and 1 month after starting growth hormone therapy were not different from before growth hormone [1.67 +/- 0.26 x 10(-4) (pmol/l)-1 min-1]. SI after 6 months of growth hormone [0.67 +/- 0.15 x 10(-4) (pmol/l)-1 min-1] was lower than before and 1 week after growth hormone (p < 0.005). SI responses did not differ between groups. Sg, glucose tolerance, blood pressure, triglyceride, and cholesterol levels did not change, but the incremental insulin response increased with growth hormone therapy. Thus, in this small study 6 months of growth hormone therapy decreased SI, but did not affect other cardiovascular risk factors.