Horm Metab Res 1988; 20(9): 579-583
DOI: 10.1055/s-2007-1010889
Clinical

© Georg Thieme Verlag, Stuttgart · New York

Growth Hormone and Carbohydrate Intolerance in Cirrhosis

Talla P. Shankar, S. S. Solomon, W. C. Duckworth, Terri Jerkins, R. S. Iyer, Mary Alice Bobal
  • Departments of Medicine and Research, VA Medical Center and The University of Tennessee, Memphis, The Health Science Center, Memphis, Tennessee and VA Medical Center and The University of Indiana, Indianapolis, Indiana, U.S.A.
Further Information

Publication History

1987

1987

Publication Date:
14 March 2008 (online)

Summary

Patients with cirrhosis of the liver often have insulin resistance and elevated circulating growth hormone levels. This study was undertaken (a) to evaluate glucose intolerance, insulin resistance and abnormal growth hormone secretion and (b) to determine if GH suppression improves insulin resistance. Glucose tolerance tests (GTT), intravenous insulin tolerance tests (IVITT), arginine stimulation tests (AST) and glucose clamp studies before and during GH suppression with somatostatin were performed in a group of patients with alcohol-induced liver cirrhosis. During GTT cirrhotic subjects had a 2-hour plasma glucose of 200±9.8 ng/dl (N=14) compared to 128±8.0 ng/dl in normal controls (N=15), P < 0.001. Basal GH was elevated in cirrhotic patients and in response to arginine stimulation reached a peak of 17.0±5.4 ng/ml (N=7), compared to a peak of 11.3±1.8 ng/ml in 5 normal controls (P=NS). During IVITT patients with cirrhosis had a glucose nadir of 60.0±4.0 mg/dl (N=9), compared to 29.0±7.0 mg/dl in controls (N=5), P < 0.001. Peak GH levels during IVITT were not significantly different in cirrhotics and controls. Glucose utilization rates in 4 patients with cirrhosis of the liver before somatostatin mediated GH suppression was 3.1±0.5 mg/kg/min and 6.5±1.5 mg/kg/min during somatostatin infusion, P < 0.025.

We conclude that patients with alcohol induced cirrhosis have sustained GH elevations resulting in insulin resistance which improves after GH suppression.