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Am J Physiol Endocrinol Metab (June 10, 2003). doi:10.1152/ajpendo.00092.2003
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Submitted on February 28, 2003
Accepted on June 3, 2003

Effects of Growth Hormone (GH) on Urea, Glucose and Lipid Metabolism and Insulin Sensitivity during Fasting in GH-Deficient Patients

Helene Norrelund1*, Christian Djurhuus1, Jens Otto Lunde Jorgensen1, Soren Nielsen1, K Sreekumaran Nair2, Ole Schmitz1, Jens Sandahl Christiansen1, and Niels Moller3

1 Medical Department M, Aarhus University Hospital, Aarhus, Denmark
2 Endocrinology Division, Mayo Clinic, Rochester, Minnesota, USA
3 Institute of Experimental Clinical Research, Aarhus University Hospital, Aarhus, Denmark

* To whom correspondence should be addressed. E-mail: helenenorrelund{at}dadlnet.dk.

Fasting related states of distress pose major health problems and GH plays a key role in this context. The present study was designed to assess the effects of GH on substrate metabolism and insulin sensitivity during short-term fasting. Six GH-deficient adults underwent 42.5 hours of fasting on two occasions with and without concomitant GH replacement. Palmitate and urea fluxes were measured with steady state isotope dilution technique after infusion of [9,103H]palmitate and [13C]urea. During fasting with GH replacement palmitate concentrations and -fluxes increased by 50% [palmitate (µmol/L): 378 ± 42 (GH) vs. 244 ± 12, p < 0.05]; [palmitate (µmol/min): 412 ± 58 (GH) vs. 276 ± 42, p=0.05], and urea turnover and excretion decreased by 30-35% [Ra urea (µmol/kg/h): 336 ± 22 (GH) vs. 439 ± 43, p<0.01]; [Urea excretion (mmol/24 h): 445 ± 43 (GH) vs. 602 ± 74, p<0.05]. Insulin sensitivity (determined by a euglycemic hyperinsulinemic clamp) was significantly decreased [M-value (mg/kg/min): 1.26±0.06 (GH) vs. 2.07 ± 0.22, p<0.01] during fasting with GH replacement. In conclusion, continued GH replacement during fasting in GH-deficient adults decreases insulin sensitivity, increases lipid utilization and conserves protein.




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