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

Chul Woo Ahn, Chul Sik Kim, Jae Hyun Nam, Hai Jin Kim, Ji Sun Nam, Jong Suk Park, Eun Seok Kang, Bong Soo Cha, Sungkil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

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 < 0·05 anova) in both groups during the treatment period. Fasting C-peptide levels significantly increased, whereas insulin levels significantly decreased, in the GH-treated group, but no changes were observed in the control group. The insulin sensitivity index (ISI) was significantly increased in the GH-treated group (1·3 ± 1·4 vs. 1·9 ± 1·0%/min, P < 0·05). Conclusions: GH treatment in obese T2DM patients with poor glycaemic control is beneficial in decreasing the amount of visceral fats, and may therefore result in improvements in insulin resistance, atherosclerotic risk factors and dyslipidaemia.

Original languageEnglish
Pages (from-to)444-449
Number of pages6
JournalClinical Endocrinology
Volume64
Issue number4
DOIs
Publication statusPublished - 2006 Apr 1

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Intra-Abdominal Fat
Growth Hormone
Insulin Resistance
Type 2 Diabetes Mellitus
Fasting
Subcutaneous Fat
Insulin
Diet
Umbilicus
Glucose
Muscles
Control Groups
C-Peptide
Lipolysis
Plasminogen Activator Inhibitor 1
Therapeutics
Dyslipidemias
Thigh
Electric Impedance
Nonesterified Fatty Acids

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism

Cite this

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, Sungkil ; Kim, Kyung Rae ; Lee, Hyun Chul ; Huh, Kap Bum. / Effects of growth hormone on insulin resistance and atherosclerotic risk factors in obese type 2 diabetic patients with poor glycaemic control. In: Clinical Endocrinology. 2006 ; Vol. 64, No. 4. pp. 444-449.
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abstract = "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 < 0·05 anova) in both groups during the treatment period. Fasting C-peptide levels significantly increased, whereas insulin levels significantly decreased, in the GH-treated group, but no changes were observed in the control group. The insulin sensitivity index (ISI) was significantly increased in the GH-treated group (1·3 ± 1·4 vs. 1·9 ± 1·0{\%}/min, P < 0·05). Conclusions: GH treatment in obese T2DM patients with poor glycaemic control is beneficial in decreasing the amount of visceral fats, and may therefore result in improvements in insulin resistance, atherosclerotic risk factors and dyslipidaemia.",
author = "Ahn, {Chul Woo} and Kim, {Chul Sik} and Nam, {Jae Hyun} and Kim, {Hai Jin} and Nam, {Ji Sun} and Park, {Jong Suk} and Kang, {Eun Seok} and Cha, {Bong Soo} and Sungkil Lim and Kim, {Kyung Rae} and Lee, {Hyun Chul} and Huh, {Kap Bum}",
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Effects of growth hormone on insulin resistance and atherosclerotic risk factors in obese type 2 diabetic patients with poor glycaemic control. / 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, Sungkil; Kim, Kyung Rae; Lee, Hyun Chul; Huh, Kap Bum.

In: Clinical Endocrinology, Vol. 64, No. 4, 01.04.2006, p. 444-449.

Research output: Contribution to journalArticle

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T1 - Effects of growth hormone on insulin resistance and atherosclerotic risk factors in obese type 2 diabetic patients with poor glycaemic control

AU - Ahn, Chul Woo

AU - Kim, Chul Sik

AU - Nam, Jae Hyun

AU - Kim, Hai Jin

AU - Nam, Ji Sun

AU - Park, Jong Suk

AU - Kang, Eun Seok

AU - Cha, Bong Soo

AU - Lim, Sungkil

AU - Kim, Kyung Rae

AU - Lee, Hyun Chul

AU - Huh, Kap Bum

PY - 2006/4/1

Y1 - 2006/4/1

N2 - 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 < 0·05 anova) in both groups during the treatment period. Fasting C-peptide levels significantly increased, whereas insulin levels significantly decreased, in the GH-treated group, but no changes were observed in the control group. The insulin sensitivity index (ISI) was significantly increased in the GH-treated group (1·3 ± 1·4 vs. 1·9 ± 1·0%/min, P < 0·05). Conclusions: GH treatment in obese T2DM patients with poor glycaemic control is beneficial in decreasing the amount of visceral fats, and may therefore result in improvements in insulin resistance, atherosclerotic risk factors and dyslipidaemia.

AB - 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 < 0·05 anova) in both groups during the treatment period. Fasting C-peptide levels significantly increased, whereas insulin levels significantly decreased, in the GH-treated group, but no changes were observed in the control group. The insulin sensitivity index (ISI) was significantly increased in the GH-treated group (1·3 ± 1·4 vs. 1·9 ± 1·0%/min, P < 0·05). Conclusions: GH treatment in obese T2DM patients with poor glycaemic control is beneficial in decreasing the amount of visceral fats, and may therefore result in improvements in insulin resistance, atherosclerotic risk factors and dyslipidaemia.

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