Effects of recombinant growth hormone on visceral fat accumulation: pilot study in human immunodeficiency virus-infected adolescents.
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.
Viganò
Alessandra
A
Department of Paediatrics, L. Sacco Hospital, University of Milan, Italy. alessandra.vigano@unimi.i .
Mora
Stefano
S
Manzoni
Paola
P
Schneider
Laura
L
Beretta
Silvia
S
Molinaro
Mariadelfina
M
di Natale
Berardo
B
Brambilla
Paolo
P
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
D014280:Triglycerides; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D002784:Cholesterol