Abstract
In a child with IDDM and growth retardation (2cm/yr) GH deficiency was documented on the basis of 3 GH stimulation tests and low SmC. Under GH therapy growth rate was 5.5 cm/yr and SmC 3220 mUI/ml. Metabolic consequences of insulin deprivation were studied in situations I, II and III: I without GH, II and III 36 and 12 hrs respectively after GH injection. Normalisation of blood glucose (BG) was obtained by overnight IV insulin. At 8 am insulin was stopped and GH, glucagon, BG, FFA, OH-Butyrate were measured every hr for 6 hrs. At 8 am plasma SmC (mUI/ml) was 201 (I), 3220 (II) and 2953 (III), GH was undetectable in I and II and 7.1 ng/ml in III. At 8 am and + 6hrs glucagon (pg/ml) was 213 and 107 in I, 160 and 155 in II, 176 and 266 in III. BG (mmol/l) rose from 5.6 to 7.4 (I), 8.3 (II) and 15.6 (III), OH-Butyrate (umol/l) from 33 to 225 (I), 45 to 203 (II), and 172 to 1850 (III), FFA (umol/l) from 210 to 680 (I), 110 to 430 (II) and 670 to 1750 (III).
In conclusion : During insulin deprivation BG, FFA and OH-Butyrate rose dramatically in protocole III. This observation demonstrates the crucial role of GH in the metabolic anomalies observed in IDDM. The fact that these anomalies were seen only when GH was recently injected speaks in favor of a direct role of GH not mediated by somatomedin.
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Tubiana-Rufi, N., Levy-Marchal, C., Guillot, M. et al. DIRECT ROLE OF GH IN THE METABOLIC DERANGEMENT OF INSULIN DEPRIVATION: STUDY IN A CHILD WITH INSULIN DEPENDENT DIABETES MELLITUS (IDDM) AND GH DEFICIENCY. Pediatr Res 20, 1206 (1986). https://doi.org/10.1203/00006450-198611000-00195
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DOI: https://doi.org/10.1203/00006450-198611000-00195