A 10-Year, Prospective Study of the Metabolic Effects of Growth Hormone Replacement in Adults

Research Centre for Endocrinology and Metabolism, Department of Clinical Nutrition, Gröna Stråket 8, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden.
Journal of Clinical Endocrinology &amp Metabolism (Impact Factor: 6.21). 05/2007; 92(4):1442-5. DOI: 10.1210/jc.2006-1487
Source: PubMed


Only a few studies have investigated the effects of GH replacement in adults for more than 5 yr. OBJECTIVE/DESIGN/PATIENTS: In a prospective, open-label, single-center study, the effects of 10-yr GH replacement were determined. Eighty-seven consecutive patients (52 men and 35 women), with a mean age of 44.1 (range 22-74) yr with adult-onset GH deficiency (GHD) were included.
The initial mean dose of GH (0.98 mg/d) was reduced during the study and at yr 10 was 0.47 mg/d. The mean IGF-I sd score increased from -1.81 at baseline to 1.29 at study end. The absolute reduction in total body fat was transient. However, after correction for age and sex using a four-compartment model, the reduction in body fat was sustained during the 10-yr study period. There was a sustained improvement in serum lipid profile and after 10 yr, and blood glycosylated hemoglobin level was reduced. The treatment responses in IGF-I sd score, serum high-density lipoprotein cholesterol level, and body composition as measured using dual-energy x-ray absorptiometry were more marked in men, whereas women had a more marked reduction in blood glycosylated hemoglobin level.
The effect on the absolute amount of body fat was seen early and was transient, which could be due to the normal aging of the patients. The effects on metabolic indices were detected later, but they were sustained and even progressive throughout the study period.

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    • "The GH replacement in older subjects may not only modulate the levels of IGFs and IGFBPs but also with little gender-related differences (i.e., increase of IGF-1 and IGFBP-3 in both sexes; IGFBP-2 and IGFBP-5 increase only in men and immunoreactive insulin increase only in women) (Munzer et al. 2006). However, men may have a better response (IGF-1 levels) to GH replacement than women (Gotherstrom et al. 2007). The replacement can also increase the protein synthesis in elderly people, this effect is stronger in men when GH replacement is carried along with testosterone (Huang et al. 2005). "
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