Growth factors, glucose and insulin kinetics after low dose growth hormone therapy in HIV-lipodystrophy.
OBJECTIVE
Low-dose growth hormone (GH) administration has been suggested as a treatment for HIV-lipodystrophy.


METHODS
Postglucose GH-secretion, kinetics of insulin-like growth factors (IGFs), insulin, and glucose metabolism were examined in six male HIV-infected lipodystrophic patients (two normal-weight patients with normal glucose-tolerance (NGT), two normal-weight with impaired glucose-tolerance (IGT), and two obese patients with diabetes (DM)) during a 16 weeks open-labelled pilot-study of low-dose GH, 0.7 mg/day.


RESULTS
DM, compared to NGT and IGT, displayed an impaired rebound of GH during a 5h oral glucose-tolerance test. Near lower normal limits in all patients before GH-therapy, total and free IGF-I increased between 87 and 152% during the GH-therapy (P<0.001), approaching upper normal limits in all patients with the highest incremental percentages shown in DM. A slight and temporary reduction in insulin sensitivity was caused by a reduction in non-oxidative glucose metabolism (n=5). GH-administration reduced hepatic extraction of insulin alleviating the demand for insulin secretion (n=5). No adverse effects of GH were detected.


CONCLUSIONS
As judged from effects on circulating IGF-I, glucose metabolism, and insulin kinetics, 0.7 mg/day of GH may be expedient for treatment of HIV-infected males with lipodystrophy. Whether the patients' glucose metabolic status matters for the IGF-response to low-dose GH-therapy awaits further investigation.
Haugaard
Steen B
SB
Department of Infectious Diseases, Hvidovre University Hospital, DK-2650 Hvidovre, Copenhagen, Denmark. sbhau@dadlnet.dk
Andersen
Ove
O
Flyvbjerg
Allan
A
Ørskov
Hans
H
Madsbad
Sten
S
Iversen
Johan
J
D023241:Antiretroviral Therapy, Highly Active; D002096:C-Peptide / Q000097:blood; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005947:Glucose / Q000378:metabolism*; D005951:Glucose Tolerance Test; D013006:Growth Hormone / Q000008:administration & dosage* / Q000378:metabolism; D015658:HIV Infections / Q000150:complications; D039682:HIV-Associated Lipodystrophy Syndrome / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007328:Insulin / Q000097:blood / Q000378:metabolism / Q000493:pharmacokinetics*; D000078790:Insulin Secretion; D007334:Insulin-Like Growth Factor I / Q000032:analysis / Q000187:drug effects*; D007335:Insulin-Like Growth Factor II / Q000032:analysis / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D010084:Oxidation-Reduction; D013997:Time Factors
D002096:C-Peptide; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D007334:Insulin-Like Growth Factor I; D007335:Insulin-Like Growth Factor II; D013006:Growth Hormone; D005947:Glucose