Continuation of growth hormone therapy versus placebo in transition-phase patients with growth hormone deficiency: impact on body composition, insulin sensitivity, and thyroid function.
In a placebo-controlled, parallel study of 18 patients with a mean age of 20 years who had confirmed growth hormone (GH) deficiency, we evaluated body composition, insulin sensitivity, and glucose turnover at baseline (when all were receiving GH replacement); after 12 months of continued GH therapy or placebo; and after a 12-month open phase of GH therapy. In the placebo group, insulin sensitivity and fat mass increased and lipid oxidation decreased, whereas glucose oxidation increased (p <0.05). During the open phase, insulin sensitivity decreased in the former placebo group although body fat decreased and fat-free mass increased. Throughout the study, most hormonal and metabolic parameters remained unchanged in those receiving continued GH therapy. These results indicate that: 1-year discontinuation of GH therapy induces fat accumulation in GH-deficient adolescents without compromising insulin sensitivity; the beneficial effects of continued GH treatment on body composition do not fully counterbalance its direct insulin antagonistic effects; and GH replacement has favorable effects on iodothyronine metabolism and quality of life.
Jørgensen
Jens O L
JO
Medical Department M (Endocrinology and Diabetes), Aarhus University Hospital, Aarhus, Denmark. jolj@dadlnet.dk
Nørrelund
Helene
H
Vahl
Nina
N
Juul
Anders
A
Skakkebaek
Niels E
NE
Christiansen
Jens Sandahl
JS
D000328:Adult; D001823:Body Composition / Q000187:drug effects*; D004311:Double-Blind Method; D005260:Female; D005947:Glucose / Q000378:metabolism; D019382:Human Growth Hormone / Q000172:deficiency* / Q000627:therapeutic use*; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D050356:Lipid Metabolism; D008297:Male; D013961:Thyroid Gland / Q000187:drug effects* / Q000503:physiopathology
D007328:Insulin; D019382:Human Growth Hormone; D005947:Glucose