Growth Hormone Mediators and Glycemic Control in Youths With Type 2 Diabetes: A Secondary Analysis of a Randomized Clinical Trial
Authors' conclusion
This study suggests that changes in plasma growth hormone mediators are associated with loss of glycemic control in youth-onset T2D, with IGF-1 associated with lower risk and GHR and IGFBP-1 associated with increased risk.
Study context
- Population
- Youths aged 10 to 17 years with T2D duration <2 years, randomized to metformin, metformin plus lifestyle intervention, or metformin plus rosiglitazone, with plasma samples at baseline and 36 months; 15 university-affiliated centres; mean (SD) age 13.9 (2.0) years, 62% girls
- Participants
- 398 participants
- Comparison
- Changes in plasma growth hormone mediators from baseline to 36 months
- Primary endpoint
- Loss of glycemic control (hemoglobin A1c (HbA1c) ≥8% for 6 months or inability to wean from insulin); baseline and 36-month glycemia, insulin sensitivity, high-molecular-weight adiponectin and beta cell function
Methodological detailspost hoc, multicentre, Mean (SD) follow-up 3.9 (1.5) years; trial enrolled July 2004 to February 2009, ended 2011
- Post hoc
- Multicentre
- Mean (SD) follow-up 3.9 (1.5) years; trial enrolled July 2004 to February 2009, ended 2011
Primary result
As reported in the abstract
Glycemic failure · change baseline to 36 months
Greater increase in IGF-1: OR of glycemic failure
0.995
95% CI 0.991–0.997P < .001
Greater increase in log2 growth hormone receptor (GHR): OR of glycemic failure
1.75
95% CI 1.05–2.99P = .04
Greater increase in log2 IGFBP-1: OR of glycemic failure
1.37
95% CI 1.09–1.74P = .007
Further findings
C-peptide index · change baseline to 36 months
- Greater increase in IGF-1 (per 100-ng/mL): higher C-peptide index, β [SE] (P < .001)
- 0.015 [0.003]
- Greater increase in log2 GHR: lower C-peptide index, β [SE] (P < .001)
- −0.02 [0.006]
High-molecular-weight adiponectin · change baseline to 36 months
- Greater increase in log2 IGFBP-1: higher HMW adiponectin, β [SE] (P = .007)
- 431 [156]
Original publication
Growth Hormone Mediators and Glycemic Control in Youths With Type 2 Diabetes: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. Published 5 February 2024. doi:10.
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