首页> 外文期刊>Journal of postgraduate medicine >Effect of 12 months of recombinant human growth hormone replacement therapy on insulin sensitivity in GH-deficient adults as determined by different methods.
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Effect of 12 months of recombinant human growth hormone replacement therapy on insulin sensitivity in GH-deficient adults as determined by different methods.

机译:通过不同方法确定的12个月重组人生长激素替代疗法对GH缺乏的成年人胰岛素敏感性的影响。

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BACKGROUND: Controversial results have been obtained in measuring insulin sensitivity (S(I)) during recombinant human growth hormone (rhGH) treatment in adult growth hormone deficient (GH-deficient) patients. AIMS: The aim of our study was to estimate S(I) before and during treatment using three different methods for quantifying insulin sensitivity in GH-deficient adults treated with rhGH. SETTINGS AND DESIGN: Twenty-one GH-deficient adults were treated with rhGH during 12 months. S(I) was estimated using Minimal model analysis, Homeostatic Model of Assessment (HOMA) and Quantitative Insulin Sensitivity Check Index (QUICKI) before and after 3, 6, 9 and 12 months of rhGH therapy. MATERIAL AND METHODS: Oral Glucose Tolerance Test (OGTT) and Frequently Sampled Intravenous Glucose Tolerance Test (FSIGT) were performed in each patient at respective time intervals. QUICKI and HOMA were calculated using basal values of glucose and insulin from FSIGT. Minimal model computer analysis was calculated from glucoseand insulin data obtained during FSIGT. STATISTICAL ANALYSIS: Area under the curve for glucose, insulin and C-peptide were calculated using trapezoidal rule from OGTT data. Differences and correlations were tested using ANOVA for repeated measures, Wilcoxon's matched-paired test, paired t-test, Pearson's correlation and Bland Altman plot. RESULTS: There were no significant changes in S(I) using Minimal model analysis and QUICKI during rhGH treatment. On the contrary, HOMA analysis indicated significant deterioration in S(I) after 12 months of therapy. CONCLUSION: Our study did not demonstrate any changes in S(I) using Minimal model and QUICKI analysis, while there was significant increase in insulin resistance using HOMA model. We suggest that the choice of method for the determination of S(I) may influence the interpretation of results concerning the effect of rhGH therapy on S(I) in GH-deficient adults.
机译:背景:在成人生长激素缺乏(GH缺乏)患者的重组人生长激素(rhGH)治疗期间,在测量胰岛素敏感性(S(I))方面已获得有争议的结果。目的:我们的研究目的是使用三种不同的方法来评估治疗前和治疗过程中的S(I),以定量用rhGH治疗的GH缺乏成年人的胰岛素敏感性。设置和设计:在12个月内用rhGH治疗了21名GH缺乏的成年人。在rhGH治疗前后3、6、9和12个月,使用最小模型分析,稳态评估模型(HOMA)和定量胰岛素敏感性检查指数(QUICKI)估算S(I)。材料与方法:每位患者在各自的时间间隔进行口服葡萄糖耐量试验(OGTT)和频繁采样的静脉葡萄糖耐量试验(FSIGT)。 QUICKI和HOMA是使用FSIGT的葡萄糖和胰岛素基础值计算得出的。从FSIGT期间获得的葡萄糖和胰岛素数据计算出最小模型计算机分析。统计分析:根据OGTT数据使用梯形法则计算葡萄糖,胰岛素和C肽的曲线下面积。差异和相关性使用ANOVA进行重复测量,Wilcoxon配对匹配检验,配对t检验,Pearson相关性和Bland Altman图进行了测试。结果:在rhGH治疗期间,使用最小模型分析和QUICKI,S(I)无明显变化。相反,HOMA分析表明治疗12个月后S(I)明显恶化。结论:我们的研究没有显示使用最小模型和QUICKI分析的S(I)有任何变化,而使用HOMA模型则胰岛素抵抗显着增加。我们建议选择测定S(I)的方法可能会影响对GH缺乏成年人中rhGH治疗对S(I)的影响的结果解释。

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