Adult GH deficiency in Japanese patients: effects of GH treatment in a randomised, placebo-controlled trial.
OBJECTIVE
To evaluate the influence of factors intrinsic to the Japanese population on consequences of growth hormone deficiency (GHD) and effects of GH treatment in adult Japanese hypopituitary patients with GHD.


METHODS
A 24-week, randomised, placebo-controlled, double-blind study in 64 patients in Japan, with GHD onset during adulthood (AO; n=27) or childhood (CO; n=37). Body composition measured by dual-energy X-ray absorptiometry (DXA) was evaluated centrally. Serum IGF-I, IGF binding protein-3 (IGFBP-3) and lipid levels were determined centrally.


RESULTS
In contrast to Caucasian patients, there were no significant differences before treatment between AO and CO patients for body mass index (BMI), lean body mass (LBM) and fat mass (FM). Baseline BMI was >/=25 kg/m(2) for 32.8% of patients. For all patients combined, a significant increase in LBM and decrease in FM (P<0.001 for each) was seen with GH treatment. Serum IGF-I and IGFBP-3 were significantly lower at baseline in CO compared with AO patients, similar to Caucasian patients, and were increased in both onsets following GH treatment. Serum total and low-density lipoprotein (LDL)-cholesterol concentrations did not differ between AO and CO patients at baseline and were elevated compared with normal ranges. GH-induced decreases were significant compared with placebo for both total (P=0.036) and LDL-cholesterol (P=0.040). Glycosylated haemoglobin was increased with GH compared with placebo treatment (P=0.016) but remained within the upper limit of normal for all patients at endpoint.


CONCLUSIONS
Adult Japanese hypopituitary patients with GHD demonstrated obesity relative to healthy Japanese subjects but the clinical presentation differed from that of Caucasian patients. GH treatment improved body composition and serum cholesterol profiles of adult Japanese hypopituitary patients with GHD.
Chihara
Kazuo
K
Department of Clinical Molecular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan. chiharak@med.kobe-u.ac.jp
Koledova
Ekaterina
E
Shimatsu
Akira
A
Kato
Yuzuru
Y
Kohno
Hitoshi
H
Tanaka
Toshiaki
T
Teramoto
Akira
A
Bates
Peter C
PC
Attanasio
Andrea F
AF
D000328:Adult; D001823:Body Composition; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D006130:Growth Disorders / Q000188:drug therapy* / Q000378:metabolism; D019382:Human Growth Hormone / Q000008:administration & dosage* / Q000009:adverse effects / Q000172:deficiency; D006801:Humans; D007018:Hypopituitarism / Q000188:drug therapy* / Q000378:metabolism; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000378:metabolism; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D007564:Japan; D008297:Male; D008875:Middle Aged; D010919:Placebos; D016896:Treatment Outcome
D008078:Cholesterol, LDL; D018972:Insulin-Like Growth Factor Binding Protein 3; D010919:Placebos; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I