title: Effects of recombinant growth hormone on visceral fat accumulation: pilot study in human immunodeficiency virus-infected adolescents.
abstract: BACKGROUND
  Recombinant human GH (rhGH) reduces excess accumulation of intraabdominal adipose tissue (IAT) in lipodystrophic HIV-infected adults, whereas data in pediatric patients are lacking.
  
  
  OBJECTIVE
  The objective of this study was to assess the efficacy of rhGH treatment on lipodystrophy in HIV-infected adolescents.
  
  
  METHODS
  The study is a prospective, 24-wk open-label study of rhGH.
  
  
  METHODS
  The study was conducted at a referral center for pediatric HIV infection.
  
  
  METHODS
  Eight HIV-infected adolescents (ages, 13.7-18.5 yr), with abnormal IAT accumulation (>41 cm(2) at L4-magnetic resonance imaging) and 97 healthy controls (HC) (ages, 9.5-19.9 yr) were enrolled.
  
  
  METHODS
  rhGH was given by sc injection at a daily dose of 0.028 mg/kg.
  
  
  METHODS
  The main outcome was change in IAT at L4-magnetic resonance imaging. Body composition by dual-energy x-ray absorptiometry, glucose and lipid metabolism, and IGF-I changes were also evaluated.
  
  
  RESULTS
  All patients completed the study period; none of them showed adverse event, and no change in the daily dose of rhGH was required. The treatment was associated with a mean height increase of 2.4 cm. From baseline to wk 24, IAT area decreased significantly by a median of 34.5% (-19.2 to -70%). Fat mass decreased significantly in patients, compared with HC, with a median loss of total, trunk, and arm and leg fat mass of 10.4, 10.9, 12.7, and 5.4%, respectively. Total, arm, and leg lean masses increased significantly, compared with HC. IGF-I increased significantly, but supraphysiological values of mild degree (2-23% over the upper normal limit) were detected in only nine of 24 samples. No significant effects on glucose metabolism, triglyceride, and cholesterol levels were observed.
  
  
  CONCLUSIONS
  Our data showed that rhGH 0.028 mg/kg daily for 24 wk in HIV-infected adolescents reduces IAT, trunk, and also limb fat and increases lean mass. Overall, short-term rhGH is well tolerated and is not associated with a worsening of glucose and lipid metabolism.
authors.affiliation: Department of Paediatrics, L. Sacco Hospital, University of Milan, Italy. alessandra.vigano@unimi.i .
authors.forename: Alessandra
authors.initials: A
authors.lastname: Viganò
authors.forename: Stefano
authors.initials: S
authors.lastname: Mora
authors.forename: Paola
authors.initials: P
authors.lastname: Manzoni
authors.forename: Laura
authors.initials: L
authors.lastname: Schneider
authors.forename: Silvia
authors.initials: S
authors.lastname: Beretta
authors.forename: Mariadelfina
authors.initials: M
authors.lastname: Molinaro
authors.forename: Berardo
authors.initials: B
authors.lastname: di Natale
authors.forename: Paolo
authors.initials: P
authors.lastname: Brambilla
mesh_terms: D000273:Adipose Tissue / Q000187:drug effects* / Q000378:metabolism; D000293:Adolescent; D023241:Antiretroviral Therapy, Highly Active; D001823:Body Composition / Q000187:drug effects; D002784:Cholesterol / Q000097:blood; D005260:Female; D013006:Growth Hormone / Q000627:therapeutic use*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008060:Lipodystrophy / Q000188:drug therapy*; D008297:Male; D010865:Pilot Projects; D014280:Triglycerides / Q000097:blood
chemical_list: D014280:Triglycerides; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D002784:Cholesterol