The purpose of this study
was to investigate the involvement of growth hormone in the diurnal variation
of insulin sensitivity in healthy adults. Afternoon (16:00 hr) or night (23:00
hr) pretreatment with a subcutaneous injection of normal saline, human growth
hormone to mimic the normal nocturnal rise in growth hormone, or octreotide to
inhibit endogenous growth hormone secretion to create a state of relative
nocturnal growth hormone deficiency, was given 16 hours before undergoing the
modified insulin suppression test in healthy subjects. The morning and evening
experiments were separated by an interval of at least 3 days. Thus, each
subject was tested on six separate occasions arranged in a random order. A
higher value of the steady-state plasma glucose (SSPG) is indicative of lower
insulin sensitivity. Plasma glucose, serum insulin, insulin-like growth
factor-1, nonesterified fatty acids (NEFA), and metabolic clearance rate of
insulin (MCRI) were measured. In the normal saline and human growth hormone
groups, SSPG levels were lower in the morning than in the evening. Evening SSPG
levels, MCRI, and NEFA concentrations were higher in the participants treated
with normal saline and growth hormone than in the octreotide group. Differences
in SSPG levels between the morning and evening values were higher in the
participants pretreated with normal saline and growth hormone than in those
treated with octreotide. A diurnal variation in insulin sensitivity existed in
healthy subjects. These results provided direct evidence that the role of
growth hormone in regulating insulin sensitivity might be related to changes in
the MCRI and the metabolism of NEFA in healthy subjects.
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