Fukuoka Hidenori, Takahashi Yutaka, Iida Keiji, Kudo Takumi, Nishizawa Hitoshi, Imanaka Mari, Takeno Ryoko, Iguchi Genzo, Takahashi Kentaro, Okimura Yasuhiko, Kaji Hidesuke, Chihara Kazuo
Division of Endocrinology/Metabolism, Neurology and Hematology/Oncology Department of Clinical Molecular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Horm Res. 2008;69(3):165-71. doi: 10.1159/000112590. Epub 2008 Jan 8.
BACKGROUND/AIMS: Acromegaly is frequently accompanied with impaired glucose tolerance (IGT) and diabetes mellitus (DM). It remains unclear which factors determine the abnormal glucose tolerance status in acromegaly. In addition, diverse actions of GH and IGF-I in regulating glucose metabolism in acromegaly have not yet been well elucidated. The aim of this study was to investigate the factors associated with abnormal glucose tolerance in acromegaly.
We conducted a retrospective cross-sectional study that included 48 patients with active acromegaly. The subjects were divided into two groups by the results of 75 g OGTT: normal glucose tolerance (NGT) group (n = 19) and IGT+DM group (n = 29).
Systolic blood pressure (SBP) was significantly higher in the IGT+DM than in the NGT group. Homeostasis model assessment of beta-cell function (HOMA-beta) was significantly decreased in the IGT+DM group compared with the NGT group. Although serum GH or IGF-I levels were not different between the two groups, the IGF-I/GH ratio in the IGT+DM group was significantly lower than that in the NGT group.
We have shown that a low serum IGF-I/GH ratio was associated with abnormal glucose tolerance in acromegaly. We propose that the IGF-I/GH ratio is a useful marker to understand the metabolic status in acromegaly.
背景/目的：肢端肥大症常伴有糖耐量受损（IGT）和糖尿病（DM）。目前尚不清楚哪些因素决定了肢端肥大症患者的糖耐量异常状态。此外，生长激素（GH）和胰岛素样生长因子-1（IGF-I）在肢端肥大症患者葡萄糖代谢调节中的多种作用尚未得到充分阐明。本研究的目的是探讨肢端肥大症患者糖耐量异常相关的因素。
我们进行了一项回顾性横断面研究，纳入48例活动性肢端肥大症患者。根据75克口服葡萄糖耐量试验（OGTT）结果将研究对象分为两组：糖耐量正常（NGT）组（n = 19）和IGT+DM组（n = 29）。
IGT+DM组的收缩压（SBP）显著高于NGT组。与NGT组相比，IGT+DM组的β细胞功能稳态模型评估（HOMA-β）显著降低。尽管两组血清GH或IGF-I水平无差异，但IGT+DM组的IGF-I/GH比值显著低于NGT组。
我们发现血清IGF-I/GH比值低与肢端肥大症患者糖耐量异常有关。我们认为IGF-I/GH比值是了解肢端肥大症患者代谢状态的一个有用指标。
