THE INFLUENCE OF GROWTH HORMONE TREATMENT ON INSULIN SENSITIVITY IN CHILDREN AND ADOLESCENTS

Objective: It has been reported that long-term growth hormone (GH) treatment may impair insulin sensitivity, hepatic glucose production, and insulin-dependent glucose utilization. In our study, we examined the effects of GH treatment on insulin sensitivity in patients with GH deficiency after one year treatment.Materials and Methods: Fifty-nine patients (22 female, 37 male) with GH deficiency who received GH therapy were included in this study. Anthropometric measurements and pubertal examination of the patients were done. Fasting plasma glucose (FPG), fasting plasma insulin (FPI), HbA1c levels were measured and OGTT (1.75 g/kg, max. 75 g) was performed before and one year after treatment. HOMA-IR and Matsuda indices were calculated.Result: The mean age of the patients at the start of GH treatment was 11.6 +/- 2.6 years old. The height standard deviation score (SDS) of the patients was-2.5 +/- 0.7, and the body mass index (BMI) SDS was-0.2 +/- 1.2. After one year, height SDS was-1.8 +/- 1.0 and BMI SDS was similar compared to baseline measurements. No difference was found between the initial and first year pubertal stages of the patients. At the end of the first year, FPG and HbA1c levels did not change. When baseline and the first year results were compared, FPI, peak insulin, and total insulin were significantly higher at the first year (p=0.037; p=0.05; p=0.017), and the Matsuda index was found to be significantly lower (p=0.009). While HOMA-IR was higher in the first year, thedifference was not significant.Conclusion: We observed that short-term GH treatment caused a decrease in insulin sensitivity, but did not reach disease-caus-ing levels. It is important to monitor children receiving GH treatment for insulin resistance. We recommend further measurements of FPI and FPG, and performing OGTT to evaluate the degree of deterioration of glucose metabolism in risky patients.