Background: GH treatment may cause insulin resistance, which is associated with metabolic syndrome and co-morbidities.
Objective and hypotheses: The aim of our study was to evaluate GH deficiency (GHD) patients on GH treatment for hyperlipidemia, insulin resistance and carotid intima media thickness (CIMT) and left ventricular global longitudinal strain (GLS) and assess cardiovascular tissue level effects of insulin sensitivity.
Method: 71 GHD patients on GH treatment (54 males, 17 females) and 43 (25 males, 17 females) healthy subjects, matched for sex and age as the control group, were recruited in this study. We performed OGTT in all GHD patients. Insulin sensitivity was evaluated with HOMA-IR and Matsuda index, derived from OGTT. Atherogenic index (AI) and serum lipid levels were evaluated. CIMT and GLS were measured by Doppler and two-dimensional ultrasound techniques. SPSS 15 used for statistical analyses.
Results: As shown in the Table, there was no difference in BMI SDS between the groups. HOMA-IR, lipid levels and AI showed no statistical difference either. 31 GHD patients showed insulin resistance after OGTT, but there was no patient with glucose intolerance. CIMT and CIMT-SDS values were higher in GHD group (P=0.01; P=0.03) but there were no differences in GLS-SDS. GLS-SDS and CIMT-SDS values showed no correlation with Matsuda index and HOMA-IR.
|GHD (n=71)||Control (n=47)||P|
|Age||13.7±2.6 (14;6.8-18.8)||13.3±2.9 (13.2;6.5-18.3)||0.45|
|Height SDS||−1.7±0.9 (−1.6;−4.00.5)||−0.1±0.9 (−0.2;−1.92.2)||0.00|
|Weight SDS||−0.9±1.3 (−1.2;−2.56.5)||−0.4±0.8 (−0.4;−2.01.6)||0.01|
|BMI SDS||−0.2±1.9 (−0.6;−1.913.4)||−0.4±0.8 (−0.4;−1.91.9)||0.62|
Conclusion: GH treatment in GHD children leads to insulin resistance. CIMT and GLS as feasible techniques may serve as descriptors of possible effects of GH on cardiovascular tissue.
Funding: This work was supported by Scientific Research Projects Coordination Unit of Istanbul University (Project Number : 46983).
01 - 03 Oct 2015
European Society for Paediatric Endocrinology