title: Continuation of growth hormone therapy versus placebo in transition-phase patients with growth hormone deficiency: impact on body composition, insulin sensitivity, and thyroid function.
abstract: 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.
authors.affiliation: Medical Department M (Endocrinology and Diabetes), Aarhus University Hospital, Aarhus, Denmark. jolj@dadlnet.dk
authors.forename: Jens O L
authors.initials: JO
authors.lastname: Jørgensen
authors.forename: Helene
authors.initials: H
authors.lastname: Nørrelund
authors.forename: Nina
authors.initials: N
authors.lastname: Vahl
authors.forename: Anders
authors.initials: A
authors.lastname: Juul
authors.forename: Niels E
authors.initials: NE
authors.lastname: Skakkebaek
authors.forename: Jens Sandahl
authors.initials: JS
authors.lastname: Christiansen
mesh_terms: 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
chemical_list: D007328:Insulin; D019382:Human Growth Hormone; D005947:Glucose