Low-dose growth hormone treatment combined with diet restriction decreases insulin resistance by reducing visceral fat and increasing muscle mass in obese type 2 diabetic patients
Low-dose growth hormone treatment combined with diet restriction decreases insulin resistance by reducing visceral fat and increasing muscle mass in obese type 2 diabetic patients
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DOI：
10.1038/sj.ijo.0801636
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发表时间：
2001-08-01
影响因子：
4.9
通讯作者：
Huh, KB
中科院分区：
文献类型：
--
作者：
Nam, SY;Kim, KR;Huh, KB
目的：评估低剂量生长激素（GH）治疗联合饮食限制对新诊断肥胖 2 型糖尿病患者身体成分变化以及随之而来的胰岛素抵抗变化的影响。设计：每日 25 kcal/kg IBW 饮食与 GH（n=9；rhGH，0.15 IU/kg 体重/周）或安慰剂（n=9）的双盲安慰剂对照试验受试者：18 名新诊断的肥胖 2 型糖尿病患者（年龄 42 - 56 岁，体重指数 28.1 +/- 2.7 kg/m(2)）。测量：身体成分和脂肪分布参数（通过生物电阻抗分析仪和 CT 扫描）、血清 IGF-1；口服葡萄糖耐量试验（OGTT）期间的血清葡萄糖、胰岛素和游离脂肪酸（FFA）；糖化血红蛋白 (1c)；血清脂质谱；基线和治疗后通过正常血糖高胰岛素钳夹测量的葡萄糖处置率 (GDR)。 结果：与安慰剂治疗组相比，GH 治疗组中因脂肪减少而减少的体重分数显着更高（0.98 +/- 0.39 vs 0.52 +/- 0.32 kg/kg，P < 0.05），并且内脏脂肪面积减少更多（27.9 vs 21.6%，P < 0.05）。安慰剂治疗组的去脂体重和肌肉面积有所减少，而 CH 治疗组的去脂体重和肌肉面积均有所增加。仅 CH 治疗组的 GDR 显着增加（4.67 +/- 1.05 vs 6.95 +/- 0.91 mg/kg/min，P < 0.05）。 CH引起的GDR增加与内脏脂肪面积/肌肉面积比值的减少呈正相关（r=0.588，P=0.001）。 GH 治疗后，OGTT 期间的血清葡萄糖水平以及胰岛素和 FFA 曲线下面积以及 HbA(1c) 均显着降低。仅 GH 治疗组的 LDL 胆固醇水平有所降低。结论：低剂量 GH 治疗结合饮食限制不仅导致内脏脂肪减少，而且肌肉质量增加，从而改善肥胖 2 型糖尿病患者的胰岛素抵抗。
OBJECTIVE: To evaluate the effects of low-dose growth hormone (GH) therapy combined with diet restriction on changes in body composition and the consequent change in insulin resistance in newly-diagnosed obese type 2 diabetic patients.DESIGN: Double-blind and placebo-controlled trial of 25-kcal/kg IBW diet daily with GH (n=9; rhGH, 0.15 IU/kg body weight/week) or placebo (n = 9) for 12 weeks.SUBJECTS: Eighteen newly-diagnosed obese type 2 diabetic patients (age 42 - 56 y, body mass index 28.1 +/- 2.7 kg/m(2)).MEASUREMENTS: Body composition and fat distribution parameters (by bioelectrical impedance analyzer and CT scans), serum IGF-1; serum glucose, insulin and free fatty acid (FFA) during oral glucose tolerance test (OGTT); HbA(1c); serum lipid profiles; and glucose disposal rate (GDR) by euglycemic hyperinsulinemic clamp at baseline and after treatment.RESULTS: The fraction of body weight lost as fat lost was significantly greater (0.98 +/- 0.39 vs 0.52 +/- 0.32 kg/kg, P < 0.05) and visceral fat area was decreased more in the GH-treated group compared to the placebo-treated group (27.9 vs 21.6%, P < 0.05). Lean body mass and muscle area were reduced in the placebo-treated group, whereas an increase in both was observed in the CH-treated group. GDR the was significantly increased in only the CH-treated group (4.67 +/- 1.05 vs 6.95 +/- 0.91 mg/kg/min, P < 0.05). The CH-induced increase in GDR was positively correlated with the decrease in the ratio of visceral fat area/muscle area (r= 0.588, P= 0.001). Serum glucose levels and insulin- and FFA-area under the curve during OGTT and HbA(1c) were significantly decreased after GH treatment. LDL-cholesterol level was decreased in only the GH-treated group.CONCLUSION: Low-dose GH treatment combined with dietary restriction resulted not only in a decrease of visceral fat but also in an increase of muscle mass with a consequent improvement of the insulin resistance observed in obese type 2 diabetic patients.