Effect of insulin on the insulin-like growth factor system in XXXX with new-onset @entity1723 .

@entity1 @entity6 @entity2301 @entity442 @entity10116 @entity5100 @entity1723 @entity1017 @entity701 @entity9045
To further characterize the mechanism of impaired growth in @entity1 with @entity1723 , we examined the serum components of the insulin-like growth factor (IGF) system in 11 @entity1 with new-onset @entity1723 and followed the effect of insulinization on the IGF system longitudinally 1 day, 1 week, and 1 month after starting insulin treatment. Before insulin therapy, serum @entity442 , @entity5100 , @entity2301 ( @entity2301 ), and @entity9045 ( @entity9045 ) levels were significantly decreased, whereas @entity10116 and @entity701 were significantly increased in @entity6 @entity1 compared to those in an age-, sex-, and stage of puberty-matched control group. Random serum GH concentrations did not differ significantly. The alterations in the IGF system reversed with insulin therapy in a sequential manner. @entity10116 fell rapidly and was comparable to control values within 24 h after insulin treatment. @entity442 rose 1 week after treatment, reaching levels comparable to those in controls and continued to rise through 1 month of treatment. @entity5100 , @entity2301 , and @entity9045 showed a slower pattern of change, with their levels reaching control values only 1 month after the start of insulin treatment. Improvement in glycemic control, as determined by a change in hemoglobin-A1c, correlated positively with improvement in @entity442 , @entity5100 , @entity2301 , @entity9045 , and @entity1017 after 1 month of insulin therapy. These data are consistent with the hypothesis that changes in the IGF system in the insulinopenic state are similar to those during nutritional deprivation and may serve to minimize IGF's anabolic actions. The decreases in @entity442 , @entity5100 , and @entity2301 may in part be due to a decrease in the @entity9045 /receptor. However, the observation that an increase in serum @entity442 was observed earlier than an increase in @entity9045 and without a significant change in serum GH suggests a direct stimulatory effect of insulin on liver @entity442 production or reversal by insulin of some postreceptor defect in GH action independent of @entity9045 .
