Growth Hormone Deficiency Clinical Trial
Official title:
Comparison Between Euglycemic Hyperinsulinemic Clamp and Surrogate Indexes of Insulin Sensitivity in Children With Growth Hormone Deficiency.
Data about the impact of growth hormone treatment on insulin sensitivity in children are
quite controversial, due to the different surrogate indexes that have been used, like
Homa-IR, QUICKI, ISI-Matsuda or adipokine levels.
The investigators aimed to evaluate insulin sensitivity through the euglycemic
hyperinsulinemic clamp, considered the gold standard technique, in children affected by
growth hormone deficiency and to compare the M-value with the most commonly used surrogate
indexes of insulin sensitivity.
The investigators aimed of this study was to use the hyperinsulinemic clamp to evaluate the
impact of GH treatment on insulin-stimulated glucose utilization (M-value) in a group of
children affected by GH deficiency and to compare the clamp-derived index with the most
commonly used surrogate indexes of insulin sensitivity.
In all patients the auxological and metabolic evaluation was performed at baseline and after
12 months of GH treatment, while in controls these evaluations were only performed at
baseline. In all children the investigators measured body height, body mass index (BMI) and
waist circumference (WC). A blood sample was drawn after an overnight fast for the
measurement of glucose, insulin, Hemoglobin A1c (HbA1c) and IGF-I. This sample served as the
baseline for the oral glucose tolerance test (OGTT). Blood samples were collected every 30
min for 120 min for glucose and insulin measurements. As surrogate estimates of insulin
sensitivity the investigators used the insulin sensitivity index, a composite index derived
from the OGTT and validated by Matsuda and DeFronzo (ISI-Matsuda). On a different day, as a
gold standard measurement of insulin sensitivity the investigators performed the euglycemic
hyperinsulinemic clamp. As other insulin sensitivity markers, the serum levels of adiponectin
and resistin after an overnight fast were also measured.
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