title: Long-term effects of growth hormone therapy on intermediary metabolism and insulin sensitivity in hypopituitary adults.
abstract: Experience with growth hormone (GH) therapy in adult hypopituitarism has been gained for more than 10 years. Most of the data on GH therapy derive from studies with a duration of 2 years or less, but longer term information is required if patients are to be treated with GH replacement therapy for many years. We have studied patients after 4 years of treatment. At the end of this time, body mass index was unchanged but short-term benefits in body composition (decreased percentage body fat and increased fat-free mass) which had been evident at 2 years were still apparent. Fasting plasma glucose and the plasma glucose area under the curve during an oral glucose tolerance test were similar before and after 4 years of therapy, although fasting insulin levels were increased in comparison with baseline. Total cholesterol and low density lipoprotein cholesterol concentrations were lower at 4 years than at the outset but high density lipoprotein cholesterol and triglyceride levels were unchanged. The available evidence therefore suggests that concerns regarding glucose intolerance in patients receiving long-term GH therapy have not been substantiated. The beneficial effects on body composition, and on total and low density lipoprotein cholesterol levels, persisted over the 4 years of study.
authors.affiliation: Section of Endocrinology and Metabolic Medicine, Imperial College School of Medicine, St Mary's Hospital, London, UK.
authors.forename: D G
authors.initials: DG
authors.lastname: Johnston
authors.forename: K A
authors.initials: KA
authors.lastname: Al-Shoumer
authors.forename: A
authors.initials: A
authors.lastname: Chrisoulidou
authors.forename: E
authors.initials: E
authors.lastname: Kousta
authors.forename: S
authors.initials: S
authors.lastname: Beshyah
authors.forename: S
authors.initials: S
authors.lastname: Robinson
mesh_terms: D000328:Adult; D001823:Body Composition / Q000187:drug effects; D005947:Glucose / Q000378:metabolism; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D007018:Hypopituitarism / Q000188:drug therapy* / Q000378:metabolism; D007333:Insulin Resistance; D008074:Lipoproteins / Q000378:metabolism; D008137:Longitudinal Studies
chemical_list: D008074:Lipoproteins; D019382:Human Growth Hormone; D005947:Glucose