Section of Endocrinology, Biomedical Department of Internal and Specialist Medicine (DIBIMIS), University of Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy.
J Endocrinol Invest. 2018 Jul;41(7):789-797. doi: 10.1007/s40618-017-0805-9. Epub 2017 Dec 16.
In children, the plasma glucose value at 1 h (1hPG) during OGTT higher than 132.5 mg/dl is a predictor of alterations in glucose metabolism. We aimed to metabolically characterize GHD children according to 1hPG levels.
Fifty-one GHD children (35 M, 16 F; mean age 8.6 years), grouped according to 1hPG, were evaluated at diagnosis and after 12 months of GH treatment (GHT) and compared with 50 matched controls at baseline. Auxological parameters, insulin-like growth factor-1 (IGF-1), glucose and insulin during OGTT, lipid profile, the oral disposition index (DIo), the homeostasis model assessment estimate of insulin resistance (Homa-IR), and the insulin sensitivity index (ISI) were evaluated.
At baseline, 31.4% of GHD children and 12% of controls (p = 0.016) showed 1hPG ≥ 132.5 mg/dl. The first ones showed higher mean 1hPG (p = 0.025) and LDL cholesterol (p = 0.029) and lower HDL cholesterol (p = 0.014) than controls. GHD with higher 1hPG showed a significant decrease in DIo (p < 0.001) without improvement in lipid profile after GHT, compared with children with lower 1hPG. After 12 months, the higher 1hPG group showed lower ISI Matsuda (p = 0.047) and DIo (p < 0.001) than the lower 1hPG group. 1hPG levels proved to be positively correlated with Homa-IR (p = 0.010) and LDL cholesterol (p = 0.032) and negatively with ISI Matsuda (p = 0.001) and DIo (p = 0.019). The 1hPG value at baseline was the only independent variable significantly associated with DIo at 12 months (p = 0.041).
1hPG level at baseline may be a useful tool to identify and properly follow up children with enhanced metabolic risk who probably need more surveillance during GHT.
在儿童中，口服葡萄糖耐量试验（OGTT）1 小时时的血浆葡萄糖值（1hPG）高于 132.5mg/dl 是葡萄糖代谢改变的预测指标。我们旨在根据 1hPG 水平对 GH 缺乏（GHD）儿童进行代谢特征分析。
51 名 GHD 儿童（35 名男性，16 名女性；平均年龄 8.6 岁）根据 1hPG 水平分组，在诊断时以及 GH 治疗（GHT）12 个月后进行评估，并与 50 名基线匹配的对照组进行比较。评估了生长激素缺乏症儿童的体格参数、胰岛素样生长因子-1（IGF-1）、OGTT 期间的血糖和胰岛素、血脂谱、口服葡萄糖处置指数（DIo）、稳态模型评估胰岛素抵抗估计值（Homa-IR）和胰岛素敏感指数（ISI）。
在基线时，31.4%的 GHD 儿童和 12%的对照组（p=0.016）的 1hPG≥132.5mg/dl。前者的平均 1hPG 较高（p=0.025），LDL 胆固醇较高（p=0.029），HDL 胆固醇较低（p=0.014）。与 1hPG 较低的儿童相比，1hPG 较高的 GHD 儿童的 DIo 显著下降（p<0.001），但血脂谱改善不明显。经过 12 个月的治疗后，1hPG 较高组的 ISI Matsuda（p=0.047）和 DIo（p<0.001）均低于 1hPG 较低组。12 个月时，1hPG 水平与 Homa-IR（p=0.010）和 LDL 胆固醇（p=0.032）呈正相关，与 ISI Matsuda（p=0.001）和 DIo（p=0.019）呈负相关。基线时的 1hPG 值是与 12 个月时 DIo 唯一显著相关的独立变量（p=0.041）。
基线时的 1hPG 水平可能是一种有用的工具，可以识别和适当随访具有更高代谢风险的儿童，这些儿童在 GHT 期间可能需要更多的监测。
