Decreased Peripheral Insulin Sensitivity in Acromegalic Patients

Abstract

In 13 nondiabetic acromegalic patients glucose homeostasis was studied by use of the hyperglycaemic clamp technique and compared to a group of sex and age matched and a group of sex, age and weight matched controls. When compared to a control group of normal weight glucose stimulated insulin release (I) was significantly increased and tissue sensitivity to insulin (M/I) significantly decreased. However, no significant differences were observed when the parameters were compared with a weight matched group. Glucose stimulated insulin release correlated positively with growth hormone (GH) and somatomedin-C levels, whereas no such a correlation could be obtained for M/I. Thus, chronic growth hormone excess seems to induce hyperinsulinaemia which in turn leads to obesity and metabolic changes comparable to those of obesity.

The effects of long-term growth hormone and insulin-like growth factor-1 exposure on the development of cardiovascular, cerebrovascular and metabolic co-morbidities in treated patients with acromegaly

“…A number of previous studies have investigated the correlations of GH and IGF‐1 with specific co‐morbidities in patients with treated acromegaly, but have yielded inconsistent results. For example, both GH and IGF‐1 have been shown to correlate with insulin resistance 6–9 . However, there is conflicting evidence on which is the better predictor of insulin resistance 10–12 .…”

“…For example, both GH and IGF-1 have been shown to correlate with insulin resistance. [6][7][8][9] However, there is conflicting evidence on which is the better predictor of insulin resistance. [10][11][12] Furthermore, several studies have found no correlation between GH or IGF-1 with co-morbidities associated with acromegaly including hypertension, blood pressure, glucose tolerance and arthropathy.…”

Incidence of Diabetes Mellitus and Evolution of Glucose Parameters in Growth Hormone–Deficient Subjects During Growth Hormone Replacement Therapy

“…Both GH deficiency and GH excess are associated with disturbances of carbohydrate metabolism (2–6). Therefore special attention has been paid to changes in glucose and HbA 1c concentrations as well as glucose metabolism in GH-deficient patients during GH replacement therapy (GHRT).…”

Molecular mechanistic associations of human diseases

“…Like acromegaly, cushing syndrome can be caused by pituitary adenoma, which is the case in 70% of cushing syndrome incidences [29]. Clinical associations were previously reported for acromegaly and obesity [30] as well as for obesity and PCOS [31,32]. Cachexia has manifestations that are adverse to obesity, such as loss of weight.…”