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The Study

Substrate Metabolism and Insulin Sensitivity During Fasting in Obese Human Subjects: Impact of GH Blockade

In simple terms

This study is like a carefully controlled experiment where 9 men were studied under three different conditions in random order. Because the conditions were randomly assigned, we can say the GH blocker actually caused some of the changes seen, not just that they happened together. However, with only 9 people, we can't be super confident these results would happen in all obese people - it's like tasting one spoonful of soup and deciding you know how the whole pot tastes.

73%

Analysis score

73/ 90

Maximum 90 for a randomized controlled trial.

Where the score came from

Reporting40
Methodology57
Publication100
Statistical100
Study type (basis of the score)
Randomized Controlled Trial
Level 1b - Individual RCT
What’s the bottom line?

Researchers gave obese men a drug (pegvisomant) to block growth hormone while they fasted for 3 days. They compared this to normal fasting and a regular fed state. The drug helped their bodies respond better to insulin and produce less glucose.

Where does this study sit?

Reviews of RCTs (Meta-analyses)

Max 100

Randomized Trials

Max 90

Reviews of Cohort Studies

Max 85

Cohort Studies

Max 72

Reviews of Case-Control Studies

Max 63

Case-Control Studies

Max 58

Cross-Sectional & Case Series

Max 50

Expert Opinion

Max 5
StrongerWeaker
Randomized Trials
Level 1b
73

73 / 100

Quality score

Participants are randomly assigned to treatment or control groups, minimizing bias. The gold standard for testing whether an intervention causes an effect.

Can establish causation

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Key takeaways

Summary

Based on the study abstract and findings.

  1. 1Yes - this is significant for humans.
  2. 2The study shows that GH contributes to insulin resistance during fasting in obese people, and blocking GH almost completely reverses this effect.
  3. 3GH levels rose during fasting.
  4. 4Blocking GH reduced insulin resistance by 99% (P<0.01).
  5. 5Endogenous glucose production dropped significantly (P=0.003).
  6. 6Lipid intermediates were more suppressed during insulin clamp.

Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data

Publication

Journal

The Journal of Clinical Endocrinology & Metabolism

Year

2017

Authors

M. H. Pedersen, M. Svart, J. Lebeck, M. Bidlingmaier, H. Stødkilde-Jørgensen, S. Pedersen, N. Møller, N. Jessen, J. Jørgensen

Open Access
22 citations
Analysis v5

Related Content

Claims (10)

Assertion

When no food is consumed during fasting, insulin levels drop, leading to the breakdown of fat stores and increased burning of fat in the liver.

Mechanistic
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Assertion

In obese men, not eating for 72 hours raises growth hormone levels and lowers IGF-I levels; when growth hormone signaling is blocked with pegvisomant, IGF-I levels drop further, confirming that pegvisomant blocks growth hormone activity in this group.

Mechanistic
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Assertion

In obese men, a 72-hour fast causes insulin resistance by increasing the liver's production of glucose, and blocking the hormone growth hormone with pegvisomant reduces this insulin resistance by lowering liver glucose output by about 30%, showing that growth hormone is necessary for this effect.

Mechanistic
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Assertion

In obese men who fast for three days, blocking the hormone growth hormone with a drug called pegvisomant allows insulin to reduce fat breakdown more effectively, leading to lower levels of free fatty acids and ketones than fasting alone.

Mechanistic
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Assertion

In obese men, going without food for 72 hours raises glycerol levels and lowers cortisol and glucagon levels when growth hormone is blocked, showing that growth hormone influences the body's hormonal response to extended fasting.

Mechanistic
Read analysis
Assertion

When men with obesity fast for 3 days while also blocking growth hormone, their bodies become better at using insulin again.

Causal
Read analysis
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