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  • Enteroendocrine Connections...
    Oliveira-Santos, Alécia A; Salvatori, Roberto; Nogueira, Monica C; Bueno, Ana C; Barros-Oliveira, Cynthia S; Leal, Ângela C G B; Marinho, Cindi G; Damascena, Nayra P; Oliveira, Djane A; Melo, Manuela A; Oliveira, Carla R P; da Costa, Flavia O; dos Santos, Jéssica S S; Santos, Paula F C; Campos, Viviane C; Santos, Elenilde G; Melo, Enaldo V; Barbosa, Meirielly L A; Rocha, Ivina E S; de Castro, Margaret; Aguiar-Oliveira, Manuel H

    The journal of clinical endocrinology and metabolism, 07/2019, Letnik: 104, Številka: 7
    Journal Article

    Abstract Context GH and IGF-1 are crucial for attainment of normal body size and regulation of food intake, nutrient storage, and insulin sensitivity. Enteroendocrine connections exist between the GH–IGF-1 axis and insulin, ghrelin, and glucagon-like peptide 1 (GLP-1). The status of these connections in GH deficiency (GHD) is unknown. Objective To study the enteroendocrine connections before and after a standard meal test in a homogeneous population of adults with congenital untreated isolated GHD (IGHD) due to a mutation in the GHRH receptor gene. Design In a cross-sectional study of 20 individuals with IGHD and 20 control subjects, we measured glucose, insulin, ghrelin, and GLP-1 before and 30, 60, 120, and 180 minutes after a standardized test meal. Homeostasis model assessment index of insulin resistance (HOMA-IR) and homeostasis model assessment (HOMA)-β were calculated. Participants scored feelings of hunger, fullness, and prospective food consumption on a visual analog scale. Main Outcome Measures Area under the curve (AUC) values of glucose, insulin, ghrelin, GLP-1, hunger, fullness, and prospective food consumption. Results Fasting HOMA-IR and HOMA-β were lower in individuals with IGHD than in control subjects (P = 0.002 and P = 0.023, respectively). AUC was higher for hunger (P < 0.0001), glucose (P = 0.0157), ghrelin (P < 0.0001), and GLP-1 (P < 0.0001) and smaller for fullness (P < 0.0001) in individuals with IGHD compared with control subjects. There was no difference in AUC for prospective food consumption or insulin. Conclusions Untreated IGHD is associated with increased GLP-1 secretion and reduced postprandial ghrelin and hunger attenuation in response to a mixed meal. These enteroendocrine connections can result in a favorable outcome in terms of environmental adaptation and guaranteeing appropriate food intake and can confer metabolic benefits. In response to a mixed meal, subjects with isolated GH deficiency have blunted ghrelin suppression and secrete more GLP-1.