title: Effects of growth hormone on abnormal visceral adipose tissue accumulation and dyslipidemia in HIV-infected patients.
abstract: BACKGROUND
  Some HIV-infected patients develop fat maldistribution with visceral adipose tissue (VAT) accumulation and metabolic abnormalities. No medical treatment is approved by the US Food and Drug Administration to reduce VAT.
  
  
  METHODS
  In this double-blind trial, 245 HIV-infected patients with excess VAT were randomized to receive placebo (PL), recombinant human growth hormone (r-hGH) at a dose of 4 mg daily (DD) or 4 mg on alternate days (AD) for 12 weeks. For weeks 12 to 24, DD patients were rerandomized to PL (DD-PL) or AD (DD-AD), AD patients continued on AD (AD-AD), and PL patients were switched to DD (PL-DD).
  
  
  RESULTS
  From baseline to week 12, VAT decreased significantly compared with PL in DD (-8.6%, P < 0.001) but not in AD (-4.2%, P = 0.052). Trunk-to-limb fat ratio decreased significantly in both (P < 0.001) compared with PL, as did total cholesterol and non-high-density lipoprotein (HDL) cholesterol (-4.5% and -7.5% in DD, -4.3% and -6.2% in AD). At week 24, all groups displayed significant (P < 0.05) reductions in VAT (-5.3% to -9.5%) and trunk fat (-7.8% to -22.8%). DD-AD and AD-AD also displayed significant (P < 0.05) reductions in non-HDL cholesterol.
  
  
  CONCLUSIONS
  These results suggest that r-hGH dosed at 4 mg daily for 12 weeks decreases VAT and cholesterol concentrations in HIV-infected patients with excess VAT. The optimal regimen to sustain these effects awaits determination.
authors.affiliation: Division of GI Immunology, St. Luke's Roosevelt Hospital Center, New York, NY, USA.
authors.forename: Donald P
authors.initials: DP
authors.lastname: Kotler
authors.forename: Norma
authors.initials: N
authors.lastname: Muurahainen
authors.forename: Carl
authors.initials: C
authors.lastname: Grunfeld
authors.forename: Christine
authors.initials: C
authors.lastname: Wanke
authors.forename: Melanie
authors.initials: M
authors.lastname: Thompson
authors.forename: Michael
authors.initials: M
authors.lastname: Saag
authors.forename: Daena
authors.initials: D
authors.lastname: Bock
authors.forename: Gregg
authors.initials: G
authors.lastname: Simons
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Gertner
mesh_terms: D000273:Adipose Tissue / Q000033:anatomy & histology* / Q000187:drug effects; D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D002784:Cholesterol / Q000097:blood; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D019382:Human Growth Hormone / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010919:Placebos; D044469:Racial Groups; D015203:Reproducibility of Results; D014781:Viscera
chemical_list: D019380:Anti-HIV Agents; D010919:Placebos; D019382:Human Growth Hormone; D002784:Cholesterol