J Korean Med Sci.  2012 Feb;27(2):177-183. 10.3346/jkms.2012.27.2.177.

The Ability of beta-Cells to Compensate for Insulin Resistance is Restored with a Reduction in Excess Growth Hormone in Korean Acromegalic Patients

• Kim SK
• Suh S
• Lee JI
• Hur KY
• Chung JH
• Lee MK
• Min YK
• Kim JH
• Kim JH
• Kim KW

• KMID: 1120155
• DOI: http://doi.org/10.3346/jkms.2012.27.2.177

Abstract

The aim of this study was to assess the prevalence of diabetes and to study the effects of excess growth hormone (GH) on insulin sensitivity and beta-cell function in Korean acromegalic patients. One hundred and eighty-four acromegalic patients were analyzed to assess the prevalence of diabetes, and 52 naive acromegalic patients were enrolled in order to analyze insulin sensitivity and insulin secretion. Patients underwent a 75 g oral glucose tolerance test with measurements of GH, glucose, insulin, and C-peptide levels. The insulin sensitivity index and beta-cell function index were calculated and compared according to glucose status. Changes in the insulin sensitivity index and beta-cell function index were evaluated one to two months after surgery. Of the 184 patients, 17.4% were in the normal glucose tolerance (NGT) group, 45.1% were in the pre-diabetic group and 37.5% were in the diabetic group. The insulin sensitivity index (ISI0,120) was significantly higher and the HOMA-IR was lower in the NGT compared to the diabetic group (P = 0.001 and P = 0.037, respectively). The ISI0,120 and disposition index were significantly improved after tumor resection. Our findings suggest that both insulin sensitivity and beta-cell function are improved by tumor resection in acromegalic patients.

Keyword

Insulin Resistance; Acromegaly

MeSH Terms

Acromegaly/*diagnosis/etiology/metabolism
Adult
Asian Continental Ancestry Group
Blood Glucose/analysis
C-Peptide/analysis
Diabetes Mellitus/epidemiology
Female
Glucose Tolerance Test
Human Growth Hormone/secretion
Humans
Insulin/blood/secretion
*Insulin Resistance
Insulin-Secreting Cells/cytology/*physiology
Male
Middle Aged
Prediabetic State/epidemiology
Republic of Korea

Figure

• 

  Fig. 1 Results of the 75 g oral glucose tolerance test according to glucose status for 52 acromegalic patients.

• 

  Fig. 2 Insulin sensitivity index and β-cell function index between the diabetic, pre-diabetic, and normal glucose tolerance groups among 52 acromegalic patients. (A) ISI0,120, (B) HOMA-IR, (C) HOMA-β, (D) first phase of insulin secretion and (E) disposition index in the NGT, pre-diabetic and diabetic groups. Analysis was performed by the Kruskal-Wallis test. Data are the mean ± SD. NGT, normal glucose tolerance; NS, not significant.

• 

  Fig. 3 Change in glucose status, insulin sensitivity and β-cell function after tumor resection: (A) glucose status, (B) HOMA-IR, (C) ISI0,120, (D) HOMA-β, (E) first-phase insulin secretion, (F) second-phase insulin secretion and (G) disposition index. NGT, normal glucose tolerance; NS, not significant. Analysis was performed by Wilcoxon's signed rank test.

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