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

Abstract

In children, the plasma glucose value at 1 h (1hPG) during OGTT higher than 132.5mg/dl is a predictor of alterations in glucose metabolism. We aimed to metabolically characterize GHD children according to 1hPG levels. Fifty-one GHD children (35M, 16 F; mean age 8.6years), grouped according to 1hPG, were evaluated at diagnosis and after 12months 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. At baseline, 31.4% of GHD children and 12% of controls (p=0.016) showed 1hPG≥132.5mg/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 12months, 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 12months (p=0.041). 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.