Endocrine Abstracts

Introduction Background: Over the last decade, scientific attention has been drawn to the potential role of Growth hormone (GH) and Insulin Like Growth Factor-1 (IGF-1) in the pathogenesis and progression of T2DM. Both hormones are interrelated but exert variable effect on glucose homeostasis. While GH increases blood glucose level, IGF-1 maintain insulin secretion and enhance insulin sensitivity.

Methods: A cross sectional study conducted in the National Diabetes Centre, Baghdad, Iraq, from May 2020 to May 2021. Sixty patients with types 2 diabetes were investigated for fasting plasma glucose (FPG), GH, lGF-1 HbA1c, HOMA-IR, HOMA-B and anthropometric measures. Patients with Type 1 diabetes mellitus, thyroid disease, pituitary disease, chronic kidney disease, hepatic disease and Pregnancy were excluded from the study.

Results: There was no significant difference between gender and other variables of studied sample. There was association between HOMA-IR with HbA1c, IGF-1, fasting insulin, HOMA-B, and with QUICKI. A significant association between IGF-1 and body mass index (BMI), glycated haemoglobin (HbA1c), the duration of type 2 diabetes, quantitative insulin sensitivity index (QUICKI), and the age of patients was found. IGF-1 showed a significant negative correlation with BMI and a significant positive correlation with HbA1c and QUICKI. fasting GH correlated negatively with waist hip ratio (WHR), fasting insulin, HOMA-IR and positively with age and QUICKI. HbA1c was significant positive correlations with duration of T2DM, WHR, FPG, fasting TG, IGF-1, HOMA-IR and negatively correlated with QUICKI. There was a significant negative correlation between QUICKI index and BMI, WHR, FPG, HbA1c, fasting TG, fasting GH, Fasting insulin, and HOMA-IR. While HOMA-IR was significantly positive correlated with BMI, Fasting Plasma Glucose, HbA1c, Fasting TG and fasting insulin.

Discussion: GH and IGF-1 play a complex role in type 2 Diabetes Mellitus. In this study, IGF-1 in obese patient was low while in uncontrolled diabetes was high. GH decreased upon increased insulin resistance. Targeting IGF-1 in type 2 diabetes can be utilized as a potential therapy in the near feature. However, this needs further well designed randomized controlled trials. Conduct larger scale study to specify the cut off value of HOMA-IR for Iraq.

Conclusion: GH and IGF-1 play a complex role in type 2 Diabetes Mellitus. In this study, IGF-1 in obese patient was low, while in uncontrolled diabetes was high. GH decreased upon increased insulin resistance.

Keywords: Growth Hormone, IGF-1, Type two diabetes, insulin resistance, HOMA, QUICKE.