Reduced insulin sensitivity in adults with pseudohypoparathyroidism type 1a
R Muniyappa, MA Warren, X Zhao… - The Journal of …, 2013 - academic.oup.com
R Muniyappa, MA Warren, X Zhao, SC Aney, AB Courville, KY Chen, RJ Brychta…
The Journal of Clinical Endocrinology & Metabolism, 2013•academic.oup.comContext: Disruption of the Gsα maternal allele leads to severe obesity and insulin resistance
in mice and early-onset obesity in patients with pseudohypoparathyroidism (PHP) type 1a.
However, insulin resistance and glucose metabolism have not been systematically
characterized in patients with PHP1a. Objective, Design, and Setting: In a cross-sectional,
case-control study, we examined insulin sensitivity, β-cell function, energy expenditure (EE),
and sympathetic nervous system activity in adults with PHP1a. Study Participants: PHP1a …
in mice and early-onset obesity in patients with pseudohypoparathyroidism (PHP) type 1a.
However, insulin resistance and glucose metabolism have not been systematically
characterized in patients with PHP1a. Objective, Design, and Setting: In a cross-sectional,
case-control study, we examined insulin sensitivity, β-cell function, energy expenditure (EE),
and sympathetic nervous system activity in adults with PHP1a. Study Participants: PHP1a …
Context
Disruption of the Gsα maternal allele leads to severe obesity and insulin resistance in mice and early-onset obesity in patients with pseudohypoparathyroidism (PHP) type 1a. However, insulin resistance and glucose metabolism have not been systematically characterized in patients with PHP1a.
Objective, Design, and Setting
In a cross-sectional, case-control study, we examined insulin sensitivity, β-cell function, energy expenditure (EE), and sympathetic nervous system activity in adults with PHP1a.
Study Participants
PHP1a patients (n = 8) and healthy control subjects (n = 24) matched for age (41 ± 7 vs 41 ± 7 years [mean ± SD]), gender, and percent body fat.
Methods
Insulin sensitivity (SI), acute insulin response to glucose, and disposition index were assessed during a frequently sampled iv glucose tolerance test. Oral glucose insulin sensitivity (OGIS) was measured during a mixed meal. EE was measured using whole-room indirect calorimetry. Body composition was assessed via dual-energy x-ray absorptiometry and sympathetic nervous system activity by measuring 24-hour urinary catecholamine concentrations.
Results
PHP1a patients were less insulin-sensitive than their matched controls based upon SI and OGIS. Nondiabetic PHP1a patients tended to have a lower SI (P = .09) and reduced OGIS (P = .03). Disposition index, a composite measure of β-cell function, also tended to be lower in patients (P = .07). Total caloric intake, resting EE, total EE, meal-induced thermogenesis, and 24-hour urinary catecholamine concentrations were not significantly different between the groups.
Conclusions
Adults with PHP-1a have reduced insulin sensitivity compared with their matched controls that may contribute to the pathogenesis of glucose intolerance and diabetes in these patients.
Oxford University Press