Growth hormone receptor antagonism with pegvisomant in insulin resistant non-diabetic men: A phase II pilot study [version 1; referees: 2 approved]

F1000Research

Ethan J. Weiss¹  Ada P. Lee²  Kathleen Mulligan³  Morris Schambelan³  Elizabeth J. Murphy³ 

[1] Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, 94143, USA;Division of Cardiology, University of California, San Francisco, San Francisco, CA, 94143, USA;Division of Endocrinology, San Francisco General Hospital, San Francisco, CA, 94110, USA;

关键词: Diabetes & Obesity;    Neuro-Endocrinology & Pituitary;   

DOI  :  10.12688/f1000research.11359.1

来源: DOAJ

【 摘 要 】

Background: Growth hormone (GH) is known to affect insulin and glucose metabolism.  Blocking its effects in acromegalic patients improves diabetes and glucose metabolism. We aimed to determine the effect of pegvisomant, a GH receptor antagonist, on insulin resistance, endogenous glucose production (EGP) and lipolysis in insulin resistant non-diabetic men.  Methods: Four men between the ages of 18-62 with a BMI of 18-35kg/m2, with insulin resistance as defined by a HOMA-IR > 2.77, were treated for four weeks with pegvisomant 20 mg daily.  Inpatient metabolic assessments were performed before and after treatment. The main outcome measurements were: change after pegvisomant therapy in insulin sensitivity as measured by hyperinsulinemic euglycemic clamp; and EGP and lipolysis assessed by stable isotope tracer techniques. Results: Insulin like growth factor-1 (IGF-1) concentrations decreased from 134.0 ± 41.5 (mean ± SD) to 72.0 ± 11.7 ng/mL (p = 0.04) after 4 weeks of therapy. Whole body insulin sensitivity index (M/I 3.2 ± 1.3 vs. 3.4 ± 2.4; P = 0.82), as well as suppression of EGP (89.7 ± 26.9 vs. 83.5 ± 21.6%; p = 0.10) and Ra glycerol (59.4 ± 22.1% vs. 61.2 ± 14.4%; p = 0.67) during the clamp were not changed significantly with pegvisomant treatment. Conclusions: Blockade of the GH receptor with pegvisomant for four weeks had no significant effect on insulin/glucose metabolism in a small phase II pilot study of non-diabetic insulin resistant participants without acromegaly.

【 授权许可】

Unknown