Why do the mitochondria in people with acromegaly not work as well, since growth hormone makes mitochondria work better?

Investigation: continues into the mechanism of impaired production of ATP in acromegaly. Hypothesis include long term effects of increased GH on insulin sensitivity, increased utilization of fatty acids with subsequent impairment due to accumulation of by products of fatty acid metabolism and unspecified problems with energy flux. Some of these seem to persist even after treatment of acromegaly.