Skip to main content
SpringerLink
Log in

Effect of glycemic control on growth hormone and IGFBP-1 secretion in patients with type I diabetes mellitus

  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

Growth hormone (GH) secretion disorders have been reported in poorly controlled type I diabetes mellitus patients. Our work was aimed to evaluate GH secretion in 9 type I young diabetes mellitus patients as well as the low molecular weight IGF-binding protein secretion (IGFBP-1) in 5 of them. The patients did not show any signs of malnutrition or neurovascular complications, neither were they on any medication except for insulin. The study protocol included blood samples collection during a 24-h period for measurement of glucose, glycated hemoglobin, GHIGF-I and IGFBP-1 levels under two situations: on poor glycemic control and after 2–3 months on better control through systematic diet, low in carbohydrates and increase in insulin dosage. GH secretion data were analyzed by Cluster algorithm for pulsatility parameters; for rhythm assessment Cosinor method was used. The first study (poor control) reported significant increase of GH maximal and incremental amplitude and duration pulse values, when compared to the second study (better control). Mean 24-h secretion values as well mean GH for interpulse intervals (valleys) decreased, although not statistically significant. The fraction of pulsatile GH/24 h GH did not change significantly with better glycemic control. No changes in pulse frequency were observed. Mean IGF-I concentrations were significantly higher when patients were on better glycemic control. An ultradian variation for GH secretion was noticed in the first study (poor control) and a circadian variation in the second one (better control). IGFBP-1 analysis showed significant decrease of the mean 24-h values under better glycemic control. Linear regression analysis demonstrated a correlation between IGFBP-1 levels and fasting glucose levels. A circadian variation was present in IGFBP-1 secretion, irrespective of glycemic control. Therefore, we concluded that for type I diabetic patients: 1. GH secretion is increased on poor control, through maximal, incremental amplitude and pulse duration values; 2. IGFBP-1 values were significantly reduced and IGF-1 levels significantly higher after better glycemic control; 4. GH ultradian secretion is reported on poor control, and circadian on the better one, 5. IGFBP-1 circadian secretion occurred irrespective of glycemic control.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hayford J.T., Danney M.M., Hendrix J.A., Thompson R.G. Integrated concentrations of growth hormone in juvenile diabetes. Diabetes 29: 391, 1980.

    Article  PubMed  CAS  Google Scholar 

  2. Amiel S.A., Sherwin R.S., Hintz R.L, Gertner J.M., Press M., Tamborlane W.V. Effect of diabetes and its control on insulin-like growth factors in the young subject with type I Diabetes. Diabetes 33: 1175, 1984.

    Article  PubMed  CAS  Google Scholar 

  3. Asplin C.M., Faria A.C.S., Carlsen E.C, Vaccaro V.A., Barr R.E., Iranmesh A., Lee M.M., Veldhuis J.D., Evans W.S. Alterations in the pulsatile mode of growth hormone release in men and women with insulin-dependent diabetes mellitus. J. Clin. Endocrinol. Metab. 69: 239, 1989.

    Article  PubMed  CAS  Google Scholar 

  4. Underwoood L.E., D’Ercole A.J., Clemmons D.R., Van Wyk J.J. Paracrine functions of somatomedins. Clin. Endocrinol. Metab. 15: 59, 1986.

    Google Scholar 

  5. Hall K., Lunding G., Póvoa C Serum levels of the low molecular weight form of insulin-like growth factor binding protein in healthy subjects and patients with growth hormone deficiency acromegaly and anorexia nervosa. Acta Endocrinol. (Copenh.) 118: 321, 1988.

    CAS  Google Scholar 

  6. Póvoa C.I, Enberg G., Jörnvall H., Hall K. Isolation and characterization of a somatomedin-binding protein from mid-term human aminiotic fluid. Eur. J. Biochem. 114: 199, 1984.

    Article  Google Scholar 

  7. Baxter R.C, Cowell C.T. Diurnal rhythm of growth hormone independent binding protein for insulin-like growth factors in human plasma. J. Clin. Endocrinol. Metab. 65: 432, 1987.

    Article  PubMed  CAS  Google Scholar 

  8. Holly J.M.P., Biddlecombe R.A., Dunger D.B., Edge J.A., Amiel S.A., Howell R., Chard T., Ress L.H., Wass J.A.H. Circadian variation of GH-independent IGF-binding protein in diabetes mellitus and its relationship to insulin. A new role for insulin? Clin. Endocrinol. (Oxf.) 29: 667, 1988.

    Article  CAS  Google Scholar 

  9. Brismar K., Gutniak M., Póvoa G., Werner S., Hall K. Insulin regulates the 35 kD IGF binding protein in patients with diabetes mellitus. J. Endocrinol. Invest. 11: 599, 1988.

    Article  PubMed  CAS  Google Scholar 

  10. Suikkari A.M., Koivisto V.A., Rutauen E.M., Yki-Jarvinen H., Karonen S.L., Seppala M. Insulin regulates the serum of low molecular weight insulin-like growth factor-binding protein. J. Clin. Endocrinol. Metab. 66: 266, 1988.

    Article  PubMed  CAS  Google Scholar 

  11. Hansen A.P. Serum growth patterns in juvenile diabetes. Dan. Med. Bull. 19 (Suppl. 1): 1, 1972.

    Google Scholar 

  12. Evans W.S., Christiansen E., Faria A.C.S., Parish E., Asplin CM. Pulsatile growth hormone secretion in insulin dependent diabetes mellitus. Proc. of the 69th Annual Meeting of the Endocrine Society, Abstract n. 231, 1987.

  13. Lanes R., Recker B., Fort P., Lifshitz F. Impaired somatomedin generation test in children with insulin dependent diabetes mellitus. Diabetes 334: 156, 1985.

    Article  Google Scholar 

  14. Veldhuis J., Johnson M.L. Clustel Analysis: a simple, versatile and robust algorithm for endocrine pulse detection. Am. J. Physiol. 250 (Endocrinol. Metab. 13): E486, 1986.

    PubMed  CAS  Google Scholar 

  15. Nelson W., Tong Y.L., Lee J.K. Halberg F. Methods for cosinor — Rhytmometry. Chronobiologia 6: 305, 1979.

    PubMed  CAS  Google Scholar 

  16. Tanner J.M. Growth at adolescence, 2nd ed. C arles C. Thomas Springfield, 1962.

    Google Scholar 

  17. Hartman M.L., Veldluis J.D., Vance M.L., Faria A.C.S., Furlanetto R.W., Thorner M.O. Somatotropin pulse frequency and basal concentrations are increased in acromegaly and are reduced by successful therapy. J. Clin. Endocrinol. Metab. 70: 1375, 1990.

    Article  PubMed  CAS  Google Scholar 

  18. Würzburger M.I., Prelevic G.M., Sönken P.H., Peric L, Till S., Morris R.W. The effects of improved blood glucose on growth hormone and cortisol secretion in insulin-dependent diabetes mellitus. Clin. Endocrinol. (Oxf.) 32: 787,1990.

    Article  Google Scholar 

  19. Malone J.I. Growth and sexual maturation in children with insulin-dependent diabetes mellitus. Curr. Opin. Pediatr. 5: 494, 1993.

    PubMed  CAS  Google Scholar 

  20. Cohen H.N., Paterson K.R., Wallace A.M. Dissociation of adrenarche and gonadarche in diabetes mellitus. Clin Endocrinol (Oxf.) 20: 717, 1984.

    Article  CAS  Google Scholar 

  21. Cotterill A.M., Cowell CT., Baxta R.C., Mc Neil D., Silinik M. Regulation of the growth hormone-independent growth factor-binding protein in children. J. Clin. Endocrinol. Metab. 67: 882, 1988.

    Article  PubMed  CAS  Google Scholar 

  22. Plotsky P.M., Vale W. Patterns of growth hormone releasing factor and somatostatin into the hypophysial — portal circulation of the rat. Science 230: 461, 1985.

    Google Scholar 

  23. Tannenbaum G.S., Ling N. The interelationship of growth hormone (GH) — releasing factor and somatostatin in generation of the ultradian rhythm of GH secretion. Endocrinology 115: 1952, 1984.

    Article  PubMed  CAS  Google Scholar 

  24. Frohman L.A., Jansson J.O. Growth hormone releasing hormone. Endocr. Rev. 7: 223, 1986.

    Article  PubMed  CAS  Google Scholar 

  25. Schaper R.C., De Groot J., Roelse H., Reitsma W.D., Wluiter W.J., Doorenbos H. Effects acute elevation of blood glucose and non-esterified fatty acids levels on growth hormone-releasing hormone-stimulated growth hormone secretion in type diabetes mellitus. Acta Endocrinol. (Copenh.) 122: 27, 1990.

    Google Scholar 

  26. Press M., Tamborlane W.V., Thorner M.O., Vale W., Rivier J., Gertner J.M., Sherwin R.S. Pituitary response to growth hormone-releasing factor in diabetes. Failure of glucose mediated suppression. Diabetes 33: 804, 1984.

    Article  PubMed  CAS  Google Scholar 

  27. Masuda A., Shibasaki T., Nakahara N. The effect of glucose on growth hormone (GH) — releasing hormone-mediate GH secretion in man. J. Clin. Endocrinol. Metab. 60: 523, 1985.

    Article  PubMed  CAS  Google Scholar 

  28. Berelowitz M., Szabo M., Frohman L.A., Firestone S., Chu L, Hintz R.L. Somatomedin-C mediates growth hormone negative feedback by effects on both the hypothalamus and pituitary. Science 212: 1279, 1981.

    Article  PubMed  CAS  Google Scholar 

  29. Hall K., Johansson B.L, Póvoa G., Thalme B. Serum levels of insulin-like gowth factor (IGF) I, II and IGF binding protein in diabetic adolescents treated with continuous sub cutaneous insulin infusion. J. Int. Med. 225: 273, 1989.

    Article  CAS  Google Scholar 

  30. Holly J.M.P. The physiologycal role of IGFBP-1. Acta. Endocrinol. (Copenh.) 124: 55, 1991.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Endocrine Section Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil

    Luiz Roberto Salgado M.D., M. Nery, M. Knoepfelmacher, A. C. Lerário, S. Jana, S. M. Villares, B. L. Wajchenberg, B. Liberman & W. Nicolau

  2. Hospital Brigadeiro - INSS, São Paulo, Brazil

    Luiz Roberto Salgado M.D., M. Semer, M. Nery & B. Liberman

  3. Endocrine Section, Vitória University, Vitória, Espírito Santo, Brazil

    G. Póvoa

Authors
  1. Luiz Roberto Salgado M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Semer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Nery
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Knoepfelmacher
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. C. Lerário
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. G. Póvoa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. S. Jana
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. S. M. Villares
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. B. L. Wajchenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. B. Liberman
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. W. Nicolau
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Salgado, L.R., Semer, M., Nery, M. et al. Effect of glycemic control on growth hormone and IGFBP-1 secretion in patients with type I diabetes mellitus. J Endocrinol Invest 19, 433–440 (1996). https://doi.org/10.1007/BF03349888

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03349888

Key-words

Search

Navigation