Effect of long-term administration of recombinant human growth hormone (rhGH) on plasma erythropoietin (EPO) and haemoglobin levels in anaemic patients with adult GH deficiency.
OBJECTIVE
We investigated the effect of recombinant human GH (rhGH) on erythropoietin (EPO) and haemoglobin (Hb) concentrations in anaemic patients with adult GH deficiency.


METHODS
rhGH was administrated in 8 patients with adult GH deficiency, three males and five females, aged from 24 to 69 years, mean (+/- SD) of 48.8 +/- 16.4 years, for 1 year by means of continuous subcutaneous infusion (CSI) at a flow rate of 0.036 U/kg/day using a portable syringe pump. Blood samples were obtained in the morning after an overnight fast every week for 1 month, followed by each month before and after the start of rhGH administration.


RESULTS
Mean (+/- SE) plasma GH levels increased from 0.24 +/- 0.09 microg/l to 2.32 +/- 0.23 microg/l 1 week after the start of rhGH administration to maintain a steady state. Plasma IGF-I levels increased from 70.1 +/- 13.8 microg/l to 282.8 +/- 70.6 microg/l 1 week after the start of rhGH administration to maintain the steady state. Plasma EPO levels increased from 25.9 +/- 2.6 IU/l to 37.6 +/- 4.2 IU/l and 34.3 +/- 3.6 IU/l at 1 week and 2 weeks after the start of rhGH administration, respectively, and then decreased gradually to 14-9 +/- 2.1 IU/l at 10 months after the start of rhGH administration. Reticulocyte counts increased from 0.88 +/- 0.06% to 1.49 +/- 0.21% at 1 week. Hb concentrations increased from 103 +/- 5 g/l to 106 +/- 5 g/l at 2 weeks after the start of rhGH administration, and then increased gradually to reach the normal range.


CONCLUSIONS
We conclude that EPO secretion was stimulated in the initial 2 weeks after the start of CSI of rhGH in anaemic patients with adult GH deficiency. Increased Hb concentrations after long-term administration of rhGH might be explained by direct stimulatory effects of rhGH and IGF-I on erythroid cells, which was accompanied by suppressed EPO secretion, in combination with a more generalized indirect impact of rhGH on physical activety. These findings suggest a beneficial effect of rhGH replacement in anaemic patients with adult GH deficiency.
Sohmiya
M
M
Department of Medicine, Shimane Medical University, Izumo, Japan. motoi@shimane-med.ac.jp
Kato
Y
Y
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000740:Anemia / Q000097:blood / Q000188:drug therapy*; D004921:Erythropoietin / Q000032:analysis; D005260:Female; D013006:Growth Hormone / Q000097:blood / Q000172:deficiency*; D006454:Hemoglobins / Q000032:analysis; D019382:Human Growth Hormone / Q000008:administration & dosage; D006801:Humans; D007260:Infusion Pumps; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D008875:Middle Aged
D006454:Hemoglobins; D004921:Erythropoietin; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone