Effects of growth hormone on insulin resistance and atherosclerotic risk factors in obese type 2 diabetic patients with poor glycaemic control

• Published in: Clinical endocrinology (Oxford) 2006-04, Vol.64 (4), p.444-449
• Main Authors: Ahn, Chul Woo, Kim, Chul Sik, Nam, Jae Hyun, Kim, Hai Jin, Nam, Ji Sun, Park, Jong Suk, Kang, Eun Seok, Cha, Bong Soo, Lim, Sung Kil, Kim, Kyung Rae, Lee, Hyun Chul, Huh, Kap Bum
• Format: Article
• Language: English
• Subjects: Analysis of Variance; Atherosclerosis - prevention & control; Biological and medical sciences; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - pathology; Diabetes. Impaired glucose tolerance; Double-Blind Method; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Fundamental and applied biological sciences. Psychology; Hormone Replacement Therapy; Human Growth Hormone - therapeutic use; Humans; Insulin Resistance; Intra-Abdominal Fat - pathology; Male; Medical sciences; Middle Aged; Obesity - blood; Obesity - drug therapy; Obesity - pathology; Risk Factors; Statistics, Nonparametric; Subcutaneous Fat - pathology; Vertebrates: endocrinology
• ISSN: 0300-0664; 1365-2265
• DOI: 10.1111/j.1365-2265.2006.02490.x

Summary Objective  We aimed to evaluate the combined effects of GH treatment and diet restriction on lipolysis and anabolism, insulin resistance and atherosclerotic risk factors in obese patients with type 2 diabetes mellitus (T2DM). Subjects  This randomized, double‐blind, placebo‐controlled study included 24 obese T2DM patients (male : female = 12 : 12, mean age 53·7 ± 7·2 years) with poor glycaemic control (fasting plasma glucose 10·673 ± 1·121 mmol/l, HbA1C 9·9 ± 2·3%). Sixteen of these patients were treated with recombinant human GH (1–1·5 units/day, 5 days/week) while undergoing diet restriction and exercise for 12 weeks. Methods  Anthropometric and bioelectrical impedance measurements were undertaken to determine the lean body mass and total body fat. Computed tomography (CT) was performed to estimate visceral and subcutaneous fat distribution at the umbilicus level and the muscle area of the midthigh. Insulin resistance was measured by the insulin tolerance test (ITT) and by the homeostasis model assessment of insulin resistance (HOMA‐IR). Results  The ratios VSR (visceral fat area/subcutaneous fat area) and VMR (visceral fat area/thigh muscle area) were significantly decreased in the GH‐treated group compared to the control group. An increase in lean body mass was observed in the GH‐treated group. Levels of total cholesterol, triglyceride, free fatty acid (FFA), fibrinogen, and plasminogen activator inhibitor‐1 (PAI‐1) were significantly decreased after GH treatment. Fasting glucose levels decreased similarly (P