GH THERAPY IN TURNER GIRLS: FASTING AND STIMULATED INSULIN DURING AND AFTER TREATMENT

Abstract

GH treatment in Turner syndrome (TS) represents a risk factor for further rise of frequently increased insulin levels. Data about the reversibility of this phenomenon are missing. The aim of our study was to investigate reversibility of changes in insulin secretion in TS during and after GH treatment. 9 prepubertal girls, age (mean±SD) 8.7±1.8 yr, were treated with GH, 1 IU/kg bw/week in daily sc injections for 12 months. Then the treatment was stopped. Glucose tolerance and insulin response were measured by an iv GTT (0.5 g glucose/kg bw) before and after 3, 6, 9 and 12 months of GH treatment and 3 months after its cessation. Glucose tolerance remained unchanged during the treatment period. Fasting insulin increased from (mean±SD) 13.0±3.8 mIU/l to 22.9±11.1(9 mo, p=0.02) to 14.7±5.0 (12 mo) and to 13.5±8.2 (3 mo after treatment). Integrated insulin secretion (AUC 1st phase) was increasing from 555±154 mIU/l.min⁻¹ to 9 months (1024±377, p=0.01) and decreased at 12 months (824±268, p=0.005) and at 3 months after therapy (685±184, p=0.01). Peak insulin response to treatment was predicted by pretreatment fasting insulin (r=0.74, p=0.006). In conclusion, patients with TS exhibit an increase in fasting and stimulated insulin secretion during the first year of GH therapy. A decrease follows by the end of the first year and after therapy.

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