Insulin Sensitivity and β-Cell Function in Adults with Lifetime, Untreated Isolated Growth Hormone Deficiency
Insulin Sensitivity and β-Cell Function in Adults with Lifetime, Untreated Isolated Growth Hormone Deficiency
复制标题
DOI：
10.1210/jc.2011-2590
复制
发表时间：
2012-03-01
影响因子：
5.8
通讯作者：
Aguiar-Oliveira, Manuel H.
中科院分区：
文献类型：
--
作者：
Oliveira, Carla R. P.;Salvatori, Roberto;Aguiar-Oliveira, Manuel H.
背景：GH 会降低胰岛素敏感性 (IS)，而 IGF-I 则会增加胰岛素敏感性 (IS)。 IGF-I 似乎对 β 细胞的发育至关重要，并且在 GH 缺乏症 (GHD) 中已报道 IS 受损。目的：本研究的目的是评估由于 GHRH 受体基因纯合突变而患有未经治疗的孤立性 GHD (IGHD) 的成年患者的 IS 和 β 细胞功能。设计、设置和患者：我们对 24 名未接受过 GH 的成人 IGHD 受试者和 25 名对照进行了一项横断面研究。干预：我们进行口服葡萄糖耐量试验，在 0、30、60、90、120 和 180 分钟测量葡萄糖和胰岛素。 主要结果指标：IS 通过胰岛素抵抗稳态模型评估指数 (IR)、定量 IS 检查指数、2 小时 (OGIS2) 和 3 小时 (OGIS3) 口服葡萄糖 IS 进行评估。通过稳态模型评估指数-β、胰岛素生成指数和胰岛素-葡萄糖比值曲线下面积测定β细胞功能。结果：口服糖耐量试验期间，IGHD受试者的血糖水平较高（P < 0.0001），而胰岛素反应呈现降低趋势（P = 0.08）。 IGHD 组中糖耐量受损的人数较多 (P = 0.001)，而两组中糖尿病的发生率相似。 IGHD 中 IR 稳态模型评估指数较低（P = 0.04），定量 IS 检查指数和 OGIS2 显示无显着升高趋势（分别为 P = 0.066 和 P = 0.09）。 OGIS3 显示各组之间没有差异。 IGDH 组的稳态模型评估指数-β、胰岛素生成指数以及胰岛素和葡萄糖曲线面积比均降低（分别为 P = 0.015、P < 0.0001 和 P = 0.02）。 结论：患有终生先天性 IGHD 且未经治疗的成年受试者表现出 β 细胞功能降低，没有 IR 的证据，并且糖耐量受损的频率较高。 (临床内分泌代谢杂志 97: 1013-1019, 2012)
Context: GH reduces insulin sensitivity (IS), whereas IGF-I increases it. IGF-I seems to be critical for the development of the beta-cells, and impaired IS has been reported in GH deficiency (GHD).Objective: The aim of the study was to assess IS and beta-cell function in adult patients with untreated isolated GHD (IGHD) due to a homozygous mutation in the GHRH receptor gene.Design, Setting, and Patients: We conducted a cross-sectional study in 24 GH-naive adult IGHD subjects and 25 controls.Intervention: We performed an oral glucose tolerance test with glucose and insulin measurements at 0, 30, 60, 90, 120, and 180 min.Main Outcome Measures: IS was assessed by homeostasis model assessment index of insulin resistance (IR), quantitative IS check index, oral glucose IS in 2 h (OGIS2) and 3 h (OGIS3). beta-Cell function was assayed by homeostasis model assessment index-beta, insulinogenic index, and area under the curve of insulin-glucose ratio.Results: During the oral glucose tolerance test, glucose levels were higher in IGHD subjects (P < 0.0001), whereas insulin response presented a trend toward reduction (P = 0.08). The number of individuals with impaired glucose tolerance was higher in the IGHD group (P = 0.001), whereas the frequency of diabetes was similar in the two groups. Homeostasis model assessment index of IR was lower (P = 0.04), and quantitative IS check index and OGIS2 showed a nonsignificant trend toward elevation (P = 0.066 and P = 0.09, respectively) in IGHD. OGIS3 showed no difference between the groups. Homeostasis model assessment index-beta, insulinogenic index, and ratio of the areas of the insulin and glucose curves were reduced in the IGDH group (P = 0.015, P < 0.0001, and P = 0.02, respectively).Conclusions: Adult subjects with lifetime congenital untreated IGHD present reduced beta-cell function, no evidence of IR, and higher frequency of impaired glucose tolerance. (J Clin Endocrinol Metab 97: 1013-1019, 2012)