Role of the steroids, SHBG, IGF-1, IGF BP-3 and growth hormone in glucose metabolism disorders during long-term treatment with low doses of glucocorticoids

BACKGROUND: The relationships between selected steroids, SHBG, growth hormone, IGF-1, IGF BP-3 and indicators of glucose metabolism were studied in the group of 20 female patients (15-20 yrs) on long-term treatment with low prednisone doses (< 0.3 mg/kg/day) (baseline phase) and after adding 1000 mg of metformin per day for following 6 months to improve impaired glucose metabolism (control phase).

METHODS AND RESULTS: Lower basal DHEAS and DHEA (DHEA/S) levels were found as compared with reference values. Only DHEAS level returned into the reference range after the treatment with metformin. Decrease of DHEA/S depended on the doses (DHEAS -0.7621, DHEA -0.7685). Positive correlations between DHEA/S and of the results insulin tolerance were found as at the baseline (+0.4452, resp. +0.4455) as well as in the control period after the metformin administration (+0.7549, resp. +0.6073). Testosterone (T) and dihydrotestosterone(DHT) values were within the reference range during the whole study. Due to very low SHBG levels higher free androgen index (FAI) was recorded in more than half of the patients. Significant relationships were revealed between former gonadal androgens and indicators of glucose metabolism deterioration at the control phase: T correlated: with fasting insulin (+0.6005), with HOMAIR (+0.5380), with insulin/glucose (+0.5261), with fasting glucose (+0.9268), with AUC glucose (+0.6792), FAI: with fasting insulin (+0.5560), with HOMAIR (+0.5269), with fasting glucose (+0.9025), with AUC glucose (+0.7143), DHT: with fasting C peptide (+0.7921), with AUC C peptide (+0.7143). SHBG correlated: with fasting glucose (-0.6519), and with AUC glucose (-0.5868). The tendency of GH to lower, and IGF-1, IGF BP-3 to higher values at the baseline changed at the control phase: fasting and AUC value of GH increased (signif.), while were IGF-1 (nonsignif.) and IGF BP-3 (signif.) levels decreased. Surprisingly, no correlation was observed between GH and parameters of glucose metabolism. Contrary to GH, baseline IGFBP-3 values correlated: with HOMAIR (+0.5002), with insulin/glucose (+0.4860). The same relationships were found between AUC IGF BP-3 (+0.5676, +0.5559), IGF-1 (HOMAIR only +0.5412), IGF-1/IGF BP-3 (+0.5059, +0.5716) and parameters of insulin sensitivity (HOMAIR, insulin/glucose) in the control period. For the first time negative correlations between IGF-1, IGF-1 AUC, IGF BP-3, IGF-1/IGF BP-3 and somatostatin blood levels were discovered at the control phase.

CONCLUSIONS: The study brought a number of new information about the importance of the "non-classical" glucoregulatory hormones in impairment of glucose metabolism, during long-term administration of low prednisone doses. The results suggest, that without normalisation of low DHEA/S, SHBG and high FAI levels it would not be possible to correct glucose metabolism properly in patients with long-term glucocorticoid therapy.

Medienart:

Artikel

Erscheinungsjahr:

2002

Erschienen:

2002

Enthalten in:

Zur Gesamtaufnahme - volume:141

Enthalten in:

Casopis lekaru ceskych - 141(2002), 3 vom: 15. Feb., Seite 89-95

Sprache:

Tschechisch

Weiterer Titel:

Vztah nĕkterých steroidů, SHBG, IGF-1, IGF BP-3 a růstového hormonu k poruchám glycidového metabolizmu pri dlouhodobé lécbĕ nízkými dávkami glukokortikoidů

Beteiligte Personen:

Vondra, K [VerfasserIn]
Hampl, R [VerfasserIn]
Nĕmcová, D [VerfasserIn]
Hill, M [VerfasserIn]
Hoza, J [VerfasserIn]
Kot'átková, A [VerfasserIn]
Stárka, L [VerfasserIn]
Vrbíková, J [VerfasserIn]
Zamrazil, V [VerfasserIn]

Themen:

67763-96-6
9002-72-6
9100L32L2N
Androgens
English Abstract
Glucocorticoids
Glucose
Growth Hormone
Hydrocortisone
Hypoglycemic Agents
IY9XDZ35W2
Insulin
Insulin-Like Growth Factor Binding Protein 3
Insulin-Like Growth Factor I
Journal Article
Metformin
Prednisone
Research Support, Non-U.S. Gov't
Sex Hormone-Binding Globulin
VB0R961HZT
WI4X0X7BPJ

Anmerkungen:

Date Completed 18.04.2002

Date Revised 21.11.2013

published: Print

Citation Status MEDLINE

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM118077775