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Acromegaly Cases Exhibiting Increased Growth Hormone Levels during Oral Glucose Loading with Preadministration of Dipeptidyl Peptidase-4 Inhibitor

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Title: Acromegaly Cases Exhibiting Increased Growth Hormone Levels during Oral Glucose Loading with Preadministration of Dipeptidyl Peptidase-4 Inhibitor
Authors: Oba-Yamamoto, Chiho Browse this author
Kameda, Hiraku Browse this author →KAKEN DB
Miyoshi, Hideaki Browse this author
Sekizaki, Tomonori Browse this author
Takase, Takahiro Browse this author
Yanagimachi, Tsuyoshi Browse this author
Fujita, Yukihiro Browse this author
Nomoto, Hiroshi Browse this author
Cho, Kyu Yong Browse this author
Nakamura, Akinobu Browse this author
Nagai, So Browse this author
Atsumi, Tatsuya Browse this author →KAKEN DB
Keywords: acromegaly
growth hormone
glucose-dependent insulinotropic polypeptide
Issue Date: 1-Aug-2021
Publisher: 日本内科学会(The Japanese Society of Internal Medicine)
Journal Title: Internal medicine
Volume: 60
Issue: 15
Start Page: 2375
End Page: 2383
Publisher DOI: 10.2169/internalmedicine.4755-20
Abstract: Objective Glucose-dependent insulinotropic polypeptide (GIP) is speculated to worsen growth hormone (GH) hypersecretion in acromegaly and to be a cause of paradoxical increases in GH (PI-GH) during 75-g oral glucose tolerance testing (75-g OGTT). Dipeptidyl peptidase-4 inhibitors (DPP4is), which increase the circulating concentration of active GIP, are frequently administered to diabetic patients, including those with acromegaly. We aimed to determine whether or not the administration of a DPP4i increases GH concentration, especially in patients demonstrating PI-GH during a DPP4i-OGTT, in which a DPP4i was administered immediately before 75-g OGTT. Methods This prospective cross-sectional study was carried out on acromegalic patients admitted to Hokkaido University hospital between June 2011 and May 2018. The participants underwent both 75-g OGTT and DPP4i-OGTT. For those who underwent surgery, immunohistochemical staining and quantitative polymerase chain reaction (PCR) for the GIP receptor (GIPR) were performed on the resected pituitary adenomas. Results Twenty-five percent of the participants had PI-GH confirmed (3 of 12 cases). Two of the three participants who demonstrated PI-GH exhibited higher circulating GH concentrations during DPP4i-OGTT than during OGTT. The increase in plasma glucose was reduced during DPP4i-OGTT compared to during 75-g OGTT, suggesting that the increase in GH during DPP4i-OGTT was due not to high glucose concentrations but instead increased GIP caused by the administration of DPP4i. The adenoma from one participant with PI-GH displayed positive immunostaining for GIPR and a higher GIPR messenger ribonucleic acid (mRNA) expression than the others. Conclusion DPP4i may enhance the GH secretion response during glucose loading, especially in individuals with PI-GH.
Type: article
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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