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One-hour post-load plasma glucose level is associated with a worse metabolic profile in children with GH deficiency

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Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusions

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.

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Authors and Affiliations

  1. Section of Endocrinology, Biomedical Department of Internal and Specialist Medicine (DIBIMIS), University of Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy

    A. Ciresi & C. Giordano

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  1. A. Ciresi
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  2. C. Giordano
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Correspondence to C. Giordano.

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Conflict of interest

All authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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At the time of hospitalization, an informed consent for the scientific use of the data was obtained from individual participants included in the study and their parents.

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This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.

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The authors hereby confirm that neither the manuscript nor any part of it has been published or is being considered for publication elsewhere. By signing this letter, each of us acknowledges that he or she participated sufficiently in the work to take public responsibility for its content.

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Ciresi, A., Giordano, C. One-hour post-load plasma glucose level is associated with a worse metabolic profile in children with GH deficiency. J Endocrinol Invest 41, 789–797 (2018). https://doi.org/10.1007/s40618-017-0805-9

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