ECE2008 Poster Presentations Growth and development (14 abstracts)
Evaluation of insulin sensitivity in growth hormone (GH) deficient children before and at the end of rhGH therapy
Silvia Savastio 1 , Simonetta Bellone 1 , Jaele Bellone 1 , Fiorella Zanetta 1 , Giuseppina Di Dio 1 , Sara Giacoma 1 , Antonella Petri 1 , Flavia Prodam 1 , Ginevra Corneli 1 , Gianni Bona 1 & Gianluca Aimaretti 2
1Division of Pediatrics, University of Piemonte Orientale, Novara, Italy; 2Division of Endocrinology, Department of Clinical and Experimental Medicine, University of Piemonte Orientale, Novara, Italy.
Introduction: Therapy with recombinant GH (rhGH) allows GH-deficient children (GHD) to reach an adequate adult stature. Previous studies have reported a significant rise in serum insulin levels during GH therapy. It has been demonstrated that insulin resistance is a risk factor for the development of DMT2, atherosclerosis, dyslipidemia and hypertension.
Subjects and methods: Aim of our study was to evaluate changes in insulin sensitivity in a group of GHD children longitudinally followed during rhGH treatment. We measured fasting glucose and insulin levels and after oral glucose tolerance test (OGTT) in 11 GHD children (seven males and four females) at three times: 1) before starting of GH therapy (BT); 2) during the last year of therapy (T1); 3) 6 months (T6) after stopped therapy. At BT children presented age of 9.2±0.7 years, height SDS −1.9±0.2, while during T1 age was 15.4±0.3 years, height SDS −1.2±0.2. GH treatment was administered subcutaneously at a mean dosage of 0.2–0.3 mg/kg per week.
Results: No children showed impaired glucose tolerance or DMT2 during the therapy. Basal glucose levels were similar among the three times. Glucose levels in response to OGTT were statistically higher at T1 compared to BT and T6 (P<0.007). Fasting and during OGTT insulin levels were higher at T1 compared to BT and T6 (P<0.03). HOMA-IR index at T1 was higher compared to BT and T6 (P<0.03). Insulin sensitivity index as ISI was lower at T1 compared to BT and T6 (P<0.01).
Conclusions: Insulin sensitivity decreased during rhGH therapy, even if without the onset of impaired glucose tolerance, and was restored after stopping treatment. It remains to be clarified if this variation of insulin sensitivity during and after rhGH treatment could be related to changes in body composition and pubertal development or to rhGH treatment itself.
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