Hormonal and metabolic responses of untrained, moderately trained, and highly trained men to three exercise intensities

Untrained, moderately trained (runners, 15 to 25 mi/wk), and highly trained (runners, greater than 45 mi/wk) men participated in graded treadmill exercise at 50%, 70%, and 90% of their maximal oxygen consumption to quantify the relation between intensity of exercise and sympathetic nervous system and metabolic responses. Sympathetic system activation was noted at all intensities tested and was proportional to the relative exercise intensity. The magnitudes of the norepinephrine (NE) and epinephrine (E) responses were similar in all three groups of men at each relative exercise intensity and correlated with the magnitudes of change in levels of circulating plasma adrenocorticotropin hormone, cortisol, lactate (La), phosphate (Pi), and glucose (GI). The magnitudes of change in concentrations of La, Pi, and GI were also similar for the three groups at each relative exercise intensity. In contrast, a lower degree of sympathetic system activation in response to a given absolute workload was noted in the moderately and highly trained men as compared to that of the untrained men. Sympathetic and metabolic responses to exercise are similar under conditions of comparable relative exercise intensities, regardless of conditioning level. The sympathetic-adrenal medullary system is more sensitive to exercise than the hypothalamic-pituitary-adrenal axis. For a given absolute workload, the degree of activation significantly lower in trained individuals.     

Changes in serum leptin concentrations in overweight Japanese men after exercise

AIM: To investigate the link between serum leptin concentrations and exercise. DESIGN: Cross-sectional and longitudinal studies of an exercise intervention. SUBJECTS: 110 Japanese overweight men aged 32-59 years were recruited. At baseline, the average body mass index (BMI) was 28.5 +/- 2.5 kg/m2. From this group, we used data of 36 overweight men (BMI, 28.9 +/- 2.3) for a 1-year exercise programme. MEASUREMENTS: Leptin was measured at baseline and after 1 year. Fat distribution was evaluated by visceral fat (V) and subcutaneous fat (S) areas measured with computed tomography (CT) scanning at umbilical levels. Anthropometric parameters, aerobic exercise level, muscle strength and flexibility were also investigated at baseline and after 1 year. RESULTS: In the first analysis, using cross-sectional data, leptin was significantly correlated with total body fat (r = 0.760, p < 0.01), V (r = 0.383, p < 0.01) and S (r = 0.617, p < 0.01) areas. In the second analysis, using longitudinal data, leptin was significantly reduced after 1 year (pre 6.7 +/- 4.0 ng/ml vs. post 5.1 +/- 3.1 ng/ml, p < 0.01). Results showed that steps per day were increased, and aerobic exercise level, weight-bearing index (WBI) and insulin resistance were significantly improved. Although, there was a positive correlation between Delta leptin(positive changes in leptin after 1 year) and anthropometric measurements such as Delta body weight, Delta BMI and Delta body fat, leptin/body weight, leptin/BMI and leptin/body fat ratios were significantly reduced during exercise intervention. CONCLUSION: The present study indicated exercise significantly lowers serum leptin concentrations, and thus it may improve the leptin resistance observed in overweight Japanese men.     

The impact of one session resistance exercise on plasma adiponectin and RBP4 concentration in trained and untrained healthy young men

We designed this study, to investigate the predicting effect of a single resistance exercise session on serum level of RBP4 and adiponectin in trained and untrained subjects and to evaluate whether regular training may affect the response of these adipokines to exercise. Thirty four healthy young male students including 19 trained and 15 untrained participated in this study; each group was then randomly assigned to intervention and control groups. The exercise session prolonged 120 minutes intensive resistance program at 70%-80% of 1RM. The blood samples were collected just before the start of training program and 4 hours post exercise to evaluate concentration of adiponectin, RBP4 and CRP as well as other metabolic markers. The serum level of adiponectin, RBP4 and CRP was not significantly different between trained and untrained groups at baseline. More over four hours post exercise adipokines concentration and CRP didn't differ between groups. Adjusted regression model showed, basal adiponectin (β=0.59, p=<0.001) and HDL cholesterol (β=0.28, p=0.09) were the main predictors of post exercise adiponectin concentration. In addition, the basic level of RBP4 appeared to be the only predictor of after exercise RBP4 concentration (β=0.46, p=0.02). Neither one session of high intensity resistance exercise nor long term training had predicting effect on post exercise adiponectin and RBP4 concentration in healthy young men. In the other hand, the beneficial effect of acute resistance exercise training may not be reflected by changes in adiponectin, RBP4 and CRP concentration in healthy young individual no matter they trained or untrained.     

Peak and trough growth hormone (GH) concentrations influence growth and serum insulin like growth factor-1 (IGF-1) concentrations in short children.

OBJECTIVE: Growth hormone (GH) is secreted in a pulsatile fashion promoting growth and a number of diverse metabolic actions. The precise components of the pulsatile signal involved in growth regulation are unclear. DESIGN: A retrospective analysis of 24 h serum GH concentration profiles to evaluate the relative contribution of peak and trough serum GH concentrations to growth regulation, GH response to insulin induced hypoglycaemia (ITT) and serum insulin like growth factor-1 (IGF-1) concentration. PATIENTS: Fifty short prepubertal children (age 5.2-11.9 years). MEASUREMENT: Analysis of the hormone profile by a concentration distribution method that determines the concentration at or below which the serum GH concentrations in the 24 hour profile spend a percentage of the total time. The method generates an estimate of the observed concentrations (OC) below which 95% and 5% of the values in the time series lie: OC 95 (peaks) and OC5 (troughs). RESULTS: Twenty six of the children were growing at a normal rate for short children with a height velocity standard deviation score (HVSDS) between +0.4 and -0.8 whereas twenty four were growing more slowly (HVSDS between -0.9 to -3.9). The former group had a mean peak GH response to ITT of 27.3 (11.1) mU/l whereas the latter had a mean value of 8.7 (6.5) mU/l. There was no relationship between (peak and trough GH concentration) and the age of the individual or body mass index. Peak GH levels were positively related to HVSDS and serum IGF-1 values (r = 0.44; P = 0.002 and r = 0.53; P = 0.002, respectively). GH trough levels were inversely related to these measurements (r = -0.29; P = 0.05; and r = -0.46; P = 0.002, respectively). Further analysis showed that individuals with the slowest growth rates and lowest IGF-1 concentrations had the lowest peak and highest trough GH concentrations (ANOVA F = 6.0; P = 0.002). Similarly, the peak GH response to ITT was lowest in those individuals with high troughs and low peaks (ANOVA F = 9.99; P < 0.001). CONCLUSIONS: These results suggest that the peak values of a GH concentration profile influence growth rate and the IGF-1 axis whereas elevated trough values have the greatest influence on growth rate and IGF-1 values when GH peaks are low.     

Basal concentrations and acute responses of serum hormones and strength development during heavy resistance training in middle-aged and elderly men and women

Effects of 6 months of heavy resistance training combined with explosive exercises on both basal concentrations and acute responses of total and free testosterone, growth hormone (GH), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), cortisol and sex hormone-binding globulin (SHBG), as well as voluntary neural activation and maximal strength of knee extensors were examined in 10 middle-aged men (M40; 42 +/- 2 years), 11 middle-aged women (W40; 39 +/- 3 years), 11 elderly men (M70; 72 +/- 3 years), and in 10 elderly women (W70; 67 +/- 3 years). The maximal integrated electromyographic (iEMG) and 1 repetition maximum (RM) knee-extension values remained unaltered in all groups during a 1-month control period with no strength training. During the 6-month training the 1RM values increased in M40 by 27 +/- 9% (p < .001), in M70 by 16 +/- 6% (p < .001), in W40 by 28 +/- 11% (p < .001), and in W70 by 24 +/- 10% (p < .001). The iEMGs of the vastus lateralis and medialis muscles increased(p < .05-.001) in M40, M70, W40, and W70. No systematic changes occurred during the experimental period in the mean concentrations of serum total and free testosterone, DHEA, DHEAS, GH, cortisol, or SHBG. However, the mean levels of individual serum free testosterone in W70 and serum testosterone in the total group of women correlated with the individual changes recorded in strength during the training (r = .55,p <.05; and r = .43,p <.05). The single exercise session both before and after the training resulted in significant responses in serum total and free testosterone concentrations in both male groups (p <.05-.01), but not in the female groups, as well as in serum GH levels in all groups (p <.05-.01) except W70 (ns). In summary, the present strength training led to great increases in maximal strength not only in middle-aged but also in elderly men and women. The strength gains were accompanied by large increases in the maximal voluntary activation of the trained muscles. None of the groups showed systematic changes in the mean serum concentrations of hormones examined. However, a low level of testosterone, especially in older women, may be a limiting factor in strength development and testosterone could mediate interactions with the nervous system contributing to strength development. The physiological significance of the lack of acute responsiveness of serum GH to heavy resistance exercise in older women for their trainability during prolonged strength training requires further examination.     

高血清胰岛素样生长因子结合蛋白7血症与胰岛素抵抗的相关性研究

目的 研究T2DM患者血清胰岛素样生长因子结合蛋白7（IGFBP7）与坂的相关性。方法选取新诊断T2DM患者（T2DM组）137例和健康体检者（NC组）96名,测定两组FPG、FInS、血脂、C-RP、肿瘤坏死因子a（TNF-a）和IGFBP7。结果T2DM组除TC和LDL-C外,其余指标与NC组比较差异有统计学意义（P〈0．05）。按T2DM组IGFBP7四分位数将其分成4组（Q1～4）,各组间年龄、BMI、C-RP、TNF-a、Fins、HOMA-IR和HOMA-IS差异有统计学意义（P＜0．05）;新诊断T2DM患者IpFBP7与年龄、BMI、C-RP、TNF-a、Fins和HOMA-IR呈正相关（r=0．264、0．173、0．255、0．227、0．192、0．325,P〈0．05）,与HOMA-IS呈负相关（r=-0．324,P〈0．01）。年龄、C-RP、TNF-n和HOMA-IR是影响新诊断T2DM患者IGFBP7水平的独立因素（β’=0．318、0．186、0．239、0．255,P〈0．05）。结论新诊断T2DM患者IGFBP7与年龄、C-RP、TNF-a和HOMA-IR密切相关。     

Variable plasma growth hormone (GH)-releasing hormone and GH responses to clonidine, L-dopa, and insulin in normal men

The effects of synthetic GHRH-(1-44) (1 microgram/kg, iv), clonidine (0.15 mg/m2, orally), L-dopa (0.5 g, orally), and insulin (0.1 IU/kg, iv) on plasma immunoreactive (ir) GHRH and GH levels were determined in normal men, aged 31-46 yr (n = 4-8). In addition, plasma ir-GHRH and GH concentrations were determined before and after the administration of clonidine in six younger men, aged 19-25 yr. GHRH was extracted from plasma using Sep-Pak C18 cartridges and measured with a mid-portion-specific GHRH antiserum. The mean plasma ir-GHRH and GH levels ranged from 9-11 ng/L and 0.5-1.5 microgram/L, respectively, in the older men during a 2-h control study. After GHRH administration, the mean plasma ir-GHRH concentration increased to a peak of 512.5 ng/L at 3 min and GH to a peak of 9.2 micrograms/L at 10 min. Clonidine resulted in a significant increase in mean plasma GH levels (P less than 0.05) in the younger men, but not in the older men. Plasma ir-GHRH concentrations did not change after clonidine. L-Dopa increased plasma ir-GHRH at 60 min (P less than 0.05) and GH at 60-120 min (P less than 0.05). Insulin-induced hypoglycemia increased plasma GH levels (to a mean of 23.8 micrograms/L at 60 min; P less than 0.001), whereas plasma ir-GHRH levels did not change. We conclude that the mechanisms of the various GH stimulation tests differ. Some GH responses, including those induced by insulin, do not appear to be mediated by GHRH.     

Time course study of insulin secretion after 1,25-dihydroxyvitamin D3 administration

Vitamin D3 is known to be involved in pancreatic endocrine function. The rapidity of action of the biologically active form of vitamin D3, 1,25-dihydroxyvitamin D3 [1,25(OH)2D3], was studied over time (from 0-72 h) on pancreatic insulin secretion by the subsequently isolated perfused pancreas of vitamin D-deficient rats pair-fed with vitamin D-deficient control rats treated with vehicle alone. At 8 h after 1,25(OH)2D3 administration (1.3 nmol), augmentation of the insulin secretion in response to 16.6 mM glucose had already significantly appeared and reached a maximum at 14 h, and then markedly decreased to pretreatment baseline values by 36 h. In a separate experiment using 20 mM arginine as a stimulus, insulin secretion from the isolated perfused pancreas also showed a significant increase at 8 h and demonstrated a maximum response at 14 h after 1,25(OH)2D3 administration, followed by gradual decrease to 72 h. The prevailing levels of serum parameters, including calcium, phosphorus, and glucose, seemed not to be involved in this mechanism, since these were not correlated to the amount of insulin secretion by the subsequently isolated perfused pancreas. Also the observed rapid effects of 1,25(OH)2D3 on insulin secretion appear not to be related to a rapid effect of the secosteroid on increased dietary/caloric intake. These results clearly establish both the dependence of and rapid dynamics response of the perfused pancreas to the potentiating effects of in vivo administered 1,25(OH)2D3 on either glucose- or arginine-mediated insulin secretion from the perfused pancreas.     

Effects of high-intensity resistance training on untrained older men. I. Strength, cardiovascular, and metabolic responses

Most resistance training studies of older subjects have emphasized low-intensity, short-term training programs that have concentrated on strength measurements. The purpose of this study was, in addition to the determination of strength, to assess intramuscular and transport factors that may be associated with strength increments. Eighteen untrained men ages 60-75 years volunteered for the study; 9 were randomly placed in the resistance-training group (RT), and the other half served as untrained (UT) or control subjects. RT subjects performed a 16-week high-intensity (85-90% 1 repetition maximum (RT]) resistance training program (2 x/wk) consisting of 3 sets each to failure (6-8 repetitions based on 1 RM of 3 exercises): leg press (LP), half squat (HS), and leg extension (LE) with 1-2 minutes rest between sets. Pre- and post- training strength was measured for the 3 training exercises using a 1 RM protocol. Body fat was calculated using a 3-site skinfold method. Biopsies from the vastus lateralis m. were obtained for fiber type composition, cross-sectional area, and capillarization measurements. Exercise metabolism, electrocardiography, and arterial blood pressure were observed continuously during a progressive treadmill test, and resting echocardiographic data were recorded for all subjects. Pre- and post-training venous blood samples were analyzed for serum lipids. Resistance training caused significant changes in the following comparisons: % fat decreased in the RT group by almost 3%, strength improved for all exercises: LE = + 50.4%, LP = + 72.3%, HS = + 83.5%; type IIB fibers decreased and IIA fibers increased; cross-sectional areas of all fiber types (I, IIA, IIB) increased significantly, and capillary to fiber ratio increased but not significantly. No differences were noted for ECG and echocardiographic data. The RT group significantly improved treadmill performance and VO2max. Pre- and post-training serum lipids improved but not significantly. No significant changes occurred in any pre- to post-tests for the UT group. The results show that skeletal muscle in older, untrained men will respond with significant strength gains accompanied by considerable increases in fiber size and capillary density. Maximal working capacity, VO2max, and serum lipid profiles also benefited from high-intensity resistance training, but no changes were observed for HR max, or maximal responses of arterial blood pressure. Older men may not only tolerate very high intensity work loads but will exhibit intramuscular, cardiovascular, and metabolic changes similar to younger subjects.     

Time course of serum Lp(a) in men after coronary artery bypass grafting.

The serum Lp(a) time course was studied in 100 male patients who underwent coronary artery bypass grafting (CABG). The patients were randomized in a placebo (N = 50) and pravastatin treated (N = 50) group. The pravastatin regimen was 10 mg daily from the third postoperative day on and 20 mg daily after 1 week during 11 weeks. Lp(a) levels and serum lipids were analyzed at baseline, at 3 and 10 days, and at 4 and 12 weeks post-CABG. A decrease of serum Lp(a) levels at the third postoperative day was seen which parallels the changes noted with the other serum lipids when using extracorporeal circulation. In contrast with the other serum lipids, a slight but significant Lp(a) overshooting was noticed at day 10 followed by a decrease of the serum Lp(a) levels to preoperative levels 1 month after the acute event. The study clearly depicts that there is a significant time-dependent effect on the serum Lp(a) levels post-CABG and that there is no effect of treatment (pravastatin). The data also reveal that reliable postoperative Lp(a) measurements can be made at earliest 1 month post-CABG.     

Androgens and insulin resistance in type 1 diabetic men

OBJECTIVE In healthy men, both high and low serum testosterone concentrations are associated with insulin resistance, whereas low concentration of sex hormone binding globulin (SHBG) is related to reduced insulin sensitivity. The aim of our study was to examine the association of sex hormones, SHBG, dehydroeplandrosterone (DHEAS) and insulin-like growth factor binding protein-1 (IGFBP-1) on Insulin sensitivity in type 1 diabetic patients. PATIENTS We examined 23 male patients with the mean age of 29 ± 1 years, body mass index 22.9 ± 0.4 kg/m², Insulin dose 47 ± 3 units/day, glycosylated haemoglobin (HbA_1c) 7.8 ± 0.3% and duration of diabetes 13 ± 1 years. DESIGN Each patient was studied With a 4-hour euglycaemic (5.5 ± 0.1 mmol/l), hyperinsulinaemic (612 ± 26 pmol/l) clamp with indirect calorimetry. Muscle biopsies (quadriceps femoris) for the determination of glycogen synthase were performed In 15 patients before and at the end of the clamp. RESULTS insulin infusion reduced the concentrations of IGFBP-1 by 90% (P < 0.001), DHEAS by 11% (P < 0.001), and SHBG by 4% (P < 0.01), whereas free or bound testosterone levels remained unchanged. The fall in IGFBP-1 level was closely related to the basal concentration (r= 099, P < 0.001). Basal SHBG concentration Correlated directly with total (r= 0.51, P <0.05) and non-oxidative glucose disposal (r= 0.41, P < 0.05), and with the decrease in lipld oxidation (r= 0.47, P <0.05) during Insulin Infusion. The fall in SHBG was inversely related to the mean (30–240 min) FFA concentration durlng hyperinsulinaemia (r=-0.64, P < 0.001). The fractional activity of glycogen synthase at the end of insulin infusion correlated directly with fasting SHBG (r= 0.71, P <0.01) and DHEAS concentrations (r= 0.67, P <0.01). CONCLUSIONS In male type 1 diabetic patients: (1) acute hyperinsulinaemia decreases IGFBP-1, DHEAS and SHBG concentrations with the greatest decline in IGFBP-1, (2) SHBG concentration is positively associated with factors Indicating good insulin sensitivity, (3) association between fuel homeostasis and SHBG, DHEAS and insulin antagonists suggests a network of these factors In the regulation of insulin action in type 1 diabetic patients.     

Association between dynamic exercise therapy and IGF-1 and IGFBP-3 concentrations in the patients with rheumatoid arthritis

We aimed to evaluate the relationship between short-term dynamic exercise therapy and insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) levels in rheumatoid arthritis (RA) patients. Forty RA patients were assigned into dynamic or range of motion (ROM) exercise groups. Also control group carried out the same dynamic exercise protocol. Morning stiffness, pain (VAS), Health assessment questionnaire (HAQ) and Ritchie articular index (RAI) were evaluated and erythrocyte sedimentation rate, serum C-reactive protein, IGF-1 and IGFBP-3 levels of the participants were recorded. The assessments were determined before, at the 7th and 15th days of treatment. VAS and RAI scores were significantly improved by the dynamic exercises in RA patients. There were increases on IGF-1 in dynamic exercise group, although IGF-1 levels showed a decrease in ROM exercise and control groups. Also no significant changes were observed on IGFBP-3 in three groups. Our results suggest that short-term dynamic exercise therapy increases serum IGF-1 in RA patients. The manipulation of serum IGF-1 levels by dynamic exercise therapy may indicate the beneficial effects of dynamic exercise in RA patients.     

Effects of intravenous, subcutaneous, and intranasal administration of growth hormone (GH)-releasing hormone-40 on serum GH concentrations in normal men

In addition to stimulating GH release in normal subjects, GH-releasing hormone-40 (GHRH-40) stimulates GH secretion in some adults and children with GH deficiency. Recognizing that GHRH-40 may have potential as a therapeutic agent for the treatment of GH deficiency, we examined the effects of iv, sc, and intranasal (in) GHRH-40 administration on GH secretion and measured the plasma levels of immunoreactive GHRH achieved after the administration of the peptide via these different routes. Normal men were given vehicle or GHRH-40 iv (0.003, 0.01, 0.03, and 0.1 micrograms/kg; n = 10), sc (1, 3.3, and 10 micrograms/kg; n = 8), or in (3, 10, 30, and 100 micrograms/kg; n = 5). No subject had any symptoms after administration of vehicle or GHRH-40. During the 2-h period after iv administration of GHRH-40, the maximal increment in serum GH levels above basal (nanograms per ml; mean +/- SD) after the 0.1 micrograms/kg dose was 15.5 +/- 10.4 compared to 2.4 +/- 4.1 after vehicle (P = 0.0017). During the 3-h period after sc administration, when compared to the maximal increment in serum GH above basal after vehicle alone (10.2 +/- 12.9), the maximal increments above basal in serum GH were increased after both the 3.3 micrograms/kg (26.2 +/- 23.1; P = 0.022) and 10 micrograms/kg (63.6 +/- 53.5; P = 0.0003) doses. During the 3-h period after in administration, when compared to the maximal increment in serum GH above basal after vehicle alone (2.8 +/- 6.4), the maximal increments above basal in GH were higher after both the 30 micrograms/kg (18.5 +/- 10.4; P = 0.0053) and 100 micrograms/kg (21.7 +/- 8.1; P = 0.0028) doses. In addition, significant dose-response relationships were documented between the maximal increments above basal in serum GH and GHRH-40 administered by all routes. The mean (+/- SEM) peak plasma level of IR-GHRH (nanograms per ml) achieved after administration of 10 micrograms/kg GHRH-40, iv, as reported previously (66.6 +/- 17.6), was approximately 60- and 500-fold higher than the mean levels in the current study after administration of the same dose sc (1.11 +/- 0.39) or in (0.14 +/- 0.02), respectively. In summary, although GHRH-40 stimulates GH release when administered iv, sc, or in, significantly higher doses were required using the sc and in routes to achieve responses comparable to those obtained with iv administration.     

Time Course of GH and IGF-1 Levels Following Withdrawal of Long-Acting Octreotide in Acromegalic Patients

Aim: Several studies have demonstrated the efficacy of octreotide LAR administered intramuscularly at 4-week intervals in the treatment of acromegaly. In contrast, few data are available on the time course of GH and IGF-1 plasma levels following octreotide LAR withdrawal. This prompted us to study these parameters for up to 20 weeks following drug withdrawal in a group of 18 acromegalic patients treated for one yearDesign and patients: We studied 18 patients treated with octreotide LAR 10 mg (n = 2), 20 mg (n = 15) and 30 mg (n = 1) every 4 weeks for one year. GH (mean level during a 4-hour daily profile) and IGF-1 concentrations were measured at the end of treatment, just before the last injection (baseline) and then 15 ± 2weeks (first control) after the last injection. In patients with GH levels below 2.5 g/L and/or normal IGF-1at the first control, a second control was performed four to eight weeks later.Results: After one year of treatment with octreotide LAR, the mean plasma GH concentration was 1.91 ± 1.25 g/L (mean ± SE) and the mean IGF-1 concentration was 440 ± 251 g/L. Among the 18 patients, 13 had mean plasma GH concentrations below 2.5 g/L and seven could be considered as well-controlled (normal IGF1 and mean GH levels below 2.5 g/L). After treatment withdrawal, the plasma GH concentration remained below 2.5 g/L at the first and the second controls in 2 of the 13 (15%) patients with suppressed GH levels on baseline. Among the seven well-controlled patients on baseline (GH levels below 2.5 g/L and normal IGF-1), one (15%) remained well-controlled, one (15%) kept GH levels below 2.5 g/L but increased IGF-1 levels, and one (15%) kept normal IGF-1 levels but increased mean GH levels at the first control. This hormonal status remained unchanged at the second control in these 3 patients.Conclusions: These results show long-lasting suppression of GH secretion after treatment withdrawal in some acromegalic patients treated for 12 months with octreotide LAR. The duration of GH suppression after treatment withdrawal is variable. Mean GH levels remained below 2.5 g/L in 15% of our patients for up to 21 weeks following withdrawal of octreotide LAR. In practice, it may be preferable to wait several months after long-acting somatostatin analog withdrawal before reassessing hormone status. Owing this long-lasting effect, a dose reduction to 10 mg and/or a longer interval between injections could be considered for very good responders, as this would lead to considerable cost savings without affecting GH or IGF-1 control.on behalf of the French Octreotide LAR Group (See appendix)     

格列吡嗪对2型糖尿病病人血清胰岛素样生长因子及其结合蛋白的影响

目的探讨格列吡嗪治疗对2型糖尿病病人血清胰岛素样生长因子（IGF）及其结合蛋白（IGFBP）的影响。方法采用病例对照及治疗前后自身对照研究,了解糖尿病病人空腹血清IGF-1、IGF-2和IGFBP-1、IGFBP-3水平及格列吡嗪治疗2周后的改变情况。其中糖尿病组40例,正常对照组90例,两组年龄无显著性差异,P＞0.05。结果与正常对照组比,糖尿病组治疗前IGF-1水平降低（234.41±141.78vs181.76±104.48ng/mlP＜0.05）,IGFBP-1水平升高(47.65±31.78vs68.82±43.18ng/ml,P＜0.01),IGF-2和IGFBP-3改变不明显。格列吡嗪治疗后IGF-I升高(181.8±104.5vs209.0±88.2ng/ml,P＜0.05);IGFBP-1则明显下降(68.82±43.18vs43.72±34.35ng/ml,p=0.001);IGF-II,IGFBP-3无明显变化。结论格列吡嗪治疗可改善2型糖尿病所导致的血清IGF-I和IGFBP-1水平改变。