0 1 2 3 4 5 Postprandial Days of Fasting

FIGURE 8 Changes in plasma concentrations of metabolic hormones during fasting.

lipolysis, decreases glucose utilization in muscle and fat, and increases glucose production by the liver. These effects of GH are relatively small compared to the effects of diminished insulin secretion. However, persons suffering from a deficiency of GH may become hypoglycemic during fasting, while treatment with GH helps to maintain their blood glucose (Fig. 9). In the nonfasting individual, GH stimulates the liver and other tissues to secrete insulin-like growth factor-1 (IGF-1), which stimulates protein synthesis. The liver becomes insensitive to this effect of GH during fasting, and plasma concentrations of IGF-1 fall dramatically. This too may be an adaptive mechanism that maximizes availability of amino acids for gluconeogenesis and turnover of critical proteins.

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