The effects of GH replacement in adult GH-deficient patients: changes in body composition without concomitant changes in the adipokines and insulin resistance.
BACKGROUND
Growth hormone deficiency (GHD) in adult life has been associated with increased central adiposity, decreased insulin sensitivity, dyslipidaemia and increased risk of cardiovascular disease. The effects of GH replacement on adiponectin and resistin, adipokines which have a role in modulating insulin sensitivity have not been previously reported.


OBJECTIVE
To examine the effects of GH replacement on adipokine levels and insulin resistance in GHD patients.


METHODS
Seventeen adult GHD patients were examined at baseline and after 1 year of treatment with recombinant human GH (mean dose 0.31 mg/day, range 0.13-0.67 mg/day).


RESULTS
GH replacement significantly increased IGF-I levels. The mean IGF-I SD score increased from -1.98 at baseline to 0.76 at study end. GH replacement was associated with a significant reduction in percentage body fat (34.11 +/- 1.33 vs. 30.65 +/- 1.27%, P < 0.0005) and a significant increase in lean body mass (63.57 +/- 1.24 vs. 66.96 +/- 1.18%, P < 0.0004), before and after treatment, respectively. Surprisingly, there was no effect of GH replacement on the plasma levels of leptin, resistin or adiponectin or on plasma lipid profile. Insulin sensitivity did not deteriorate during GH replacement despite the known 'anti-insulin' effect of GH. Fasting glucose, insulin and insulin resistance as calculated using the homeostasis model assessment insulin resistance index (HOMA-R) were unchanged by GH treatment.


CONCLUSIONS
These data demonstrate GH replacement in adult subjects with GHD is effective in changing body composition and restoring IGF-I levels over a 12-month period; however, in our study, these changes were not accompanied by changes in adipokine levels or beneficial effects on plasma lipids or insulin resistance.
Hana
Vaclav
V
Third Department of Internal Medicine, First Faculty of Medicine, Charles University, Prague, Czech Republic.
Silha
Josef V
JV
Justova
Vlasta
V
Lacinova
Zdena
Z
Stepan
Jan J
JJ
Murphy
Liam J
LJ
D052242:Adiponectin; D000328:Adult; D001823:Body Composition / Q000187:drug effects*; D005260:Female; D013006:Growth Hormone / Q000097:blood / Q000172:deficiency*; D006729:Hormones, Ectopic / Q000097:blood*; D019382:Human Growth Hormone / Q000627:therapeutic use; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D036341:Intercellular Signaling Peptides and Proteins; D016014:Linear Models; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D011506:Proteins / Q000032:analysis*; D011994:Recombinant Proteins / Q000627:therapeutic use; D052243:Resistin
D052242:Adiponectin; D006729:Hormones, Ectopic; D007328:Insulin; D036341:Intercellular Signaling Peptides and Proteins; D008055:Lipids; D011506:Proteins; C499624:RETN protein, human; D011994:Recombinant Proteins; D052243:Resistin; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone