| 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 |
| URI: | http://hdl.handle.net/2115/83015 |
| 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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