One year of GH replacement therapy with a fixed low-dose regimen improves body composition, bone mineral density and lipid profile of GH-deficient adults.
OBJECTIVE
We have studied the effects on body composition and metabolism of a fixed low dose of growth hormone (GH), 0.6 IU (0.2 mg)/day, administered for 12 months to GH-deficient (GHD) adults.


METHODS
Prospective open-label study, using 18 GHD patients (11 women, 7 men; aged 21-58 years). All investigations were performed at baseline and after 12 months. Body composition was determined by dual energy X-ray absorptiometry.


RESULTS
Total body fat decreased (-1.74+/-2.87%) and lean body mass (LBM) increased (1.27+/-2.08 kg) after therapy (P < 0.05). Changes in truncal fat did not reach statistical significance, but a decrease varying from 0.72 to 2.78kg (1 to 8.7%) was observed in 13 (72%) patients. Bone mineral density (BMD) increased at lumbar spine, total femur and femoral neck (P < 0.05). Levels of total and low-density lipoprotein (LDL)-cholesterol were lower after therapy (P < 0.05), and their changes were directly associated with values at baseline. Insulin levels increased and the insulin resistance index worsened at 12 months (P < 0.05). Median IGF-I s.d. score was -4.30 (range, -11.03 to -0.11) at baseline and -1.73 (range, -9.80 to 2.26) at 12 months. Normal age-adjusted IGF-I levels were obtained with therapy in 5 of 11 patients who had low IGF-I levels at baseline. Changes in IGF-I levels were not correlated with any biological end point, except changes in LBM (r = 0.53, P = 0.02). Side effects were mild and disappeared spontaneously.


CONCLUSIONS
One-year of a fixed low-dose GH regimen in GHD adults resulted in a significant reduction in body fat, total cholesterol and LDL-cholesterol, and a significant increase in LBM and BMD at lumbar spine and femur, regardless of normalization of IGF-I levels. This regimen led to an elevation of insulin levels and a worsening of the insulin resistance index.
Boguszewski
Cesar L
CL
SEMPR, Serviço de Endocrinologia e Metobologia do Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Brazil. cesarluiz@hc.ufpr.br
Meister
Ludimyla H F
LH
Zaninelli
Daniele C T
DC
Radominski
Rosana B
RB
D015502:Absorptiometry, Photon; D000328:Adult; D001823:Body Composition / Q000187:drug effects*; D015519:Bone Density / Q000187:drug effects*; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D005947:Glucose / Q000378:metabolism; D018737:Hand Strength / Q000502:physiology; D020249:Hormone Replacement Therapy / Q000379:methods*; D019382:Human Growth Hormone / Q000008:administration & dosage* / Q000172:deficiency* / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000008:administration & dosage; D014280:Triglycerides / Q000097:blood
D008076:Cholesterol, HDL; D007328:Insulin; D011994:Recombinant Proteins; D014280:Triglycerides; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D005947:Glucose