Glucose metabolism abnormalities in a population of acromegalic patients

Nogueira, Cláudia; Belo, Sandra; Vinha, Eduardo; Magalhaes, Angela; Carvalho, Davide

doi:10.1530/endoabs.32.p632

EJEA

2013

DOI: 10.1530/endoabs.32.p632

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Glucose metabolism abnormalities in a population of acromegalic patients

Cláudia Nogueira¹,

Sandra Belo²,

Eduardo Vinha³

et al.

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“…In a sample of 98 acromegalics, 17 with diabetes and 39 with newly diagnosed disturbances of glucose metabolism, we demonstrated that diabetics were older, heavier and more insulin resistant (higher HOMA IR) and that they had lower insulin levels (evaluated by HOMA β), and showed a significant correlation between mean GH levels, IGF-1 and insulin resistance. 10 Risk factors for diabetes in acromegaly are: high GH/IGF-1 serum levels, older age, longer duration of the disease, a family history of DM and concomitant hypertension. Acromegaly surgical management is associated with improvements in glucose disturbances.…”

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Growth Hormone, Acromegaly and Glucose Metabolism

Carvalho¹

2014

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The GH and insulin-like growth factor-I (IGF-I) axis is not only involved in the regulation of somatic growth, but also in glucose metabolism. During fasting and stress, GH secretion is increased and these conditions may be viewed as the natural metabolic domain for GH action. GH decreases glucose uptake in adipose tissue and regulates the glucose transporter I (GLUT-I) in adipose-tissue-derived cell lines. 2 GH may antagonize adipocyte insulin action. At hepatic level, GH increases glycogenolysis, thereby increasing endogenous glucose production (EGP), which could possibly be as a result of insulin antagonism. GH-deficient children have reduced fasting plasma glucose (FPG) levels, impaired glucose tolerance (IGT), and increased insulin sensitivity due to increased glucose utilization and diminished EGP. 3,4 GH replacement increase FPG, insulin levels and EGP. 4 GH-deficient adults have elevated fasting insulin levels and show a positive correlation between fasting plasma insulin and both fat mass and waist girth, suggesting the presence of insulin resistance. GH replacement initially increases insulin resistance even more, during the first 1-6weeks of therapy, but long-term studies suggest that this subsequently reverts to unchanged insulin-sensitivity. 5 Developmental models of GH deficiency and excess indicate that GH is positively associated with β-cell mass. The reduction in GH levels observed with age and weight gain may contribute to the age-related decline in pancreatic β-cell function. Humans with long-term adult-onset GH deficiency, or with developmental isolated GHD, show IGT, 6,7 and may have an increase prevalence to diabetes mellitus (DM). 8

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Growth Hormone, Acromegaly and Glucose Metabolism

Carvalho¹

2014

JDMDC

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Glucose metabolism abnormalities in a population of acromegalic patients

Cited by 1 publication

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Growth Hormone, Acromegaly and Glucose Metabolism

Growth Hormone, Acromegaly and Glucose Metabolism

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