Sustained effects of recombinant GH replacement after 7 years of treatment in adults with GH deficiency.
BACKGROUND
The goal of GH replacement with recombinant human GH (rhGH) is to ameliorate symptoms, signs, and complications of adult GH deficiency (GHD) in the long term. To determine whether the observed short-term beneficial effects of rhGH treatment are sustained in the long term, we evaluated biochemical and anthropometric parameters after 7 years of rhGH replacement.


METHODS
After 2, 5, and 7 years of rhGH replacement, 63 adult GHD patients (30 men, 52 adult-onset GHD) were assessed. IGF-I increased during rhGH replacement, and a stable dose of rhGH was reached within 1 year of rhGH substitution. Thereafter, this individualized dose was continued.


RESULTS
Plasma levels of total cholesterol and low-density lipoprotein cholesterol decreased even after 5 years of rhGH replacement (11% decrease, P < 0.001; 22% decrease, P < 0.001 respectively). High-density lipoprotein cholesterol levels increased during 7 years of rhGH replacement (1.4 +/- 0.5 mmol/l at baseline vs 1.7 +/- 0.5 mmol/l after 7 years, P < 0.001), whereas triglyceride concentrations remained unchanged. Fasting glucose levels increased during follow-up, mainly during the first 2 years of rhGH replacement (4.4 +/- 0.7 mmol/l to 5.0 +/- 1.0 mmol/l, P < 0.001). Body mass index increased during follow-up, whereas waist circumference and waist-to-hip ratio remained unchanged. Diastolic blood pressure decreased (P = 0.002), but when patients using antihypertensive medication were excluded this decrease did not reach significance (P = 0.064). Systolic blood pressure remained unchanged.


CONCLUSIONS
The beneficial effects of rhGH replacement, described after short-term rhGH replacement, are sustained in the long term up to 7 years.
van der Klaauw
A A
AA
Department of Endocrinology and Metabolic Diseases C4-R, Leiden University Medical Center, Po Box 9600, 2300 RC, Leiden, The Netherlands. a.a.van_der_klaauw@lumc.nl
Romijn
J A
JA
Biermasz
N R
NR
Smit
J W A
JW
van Doorn
J
J
Dekkers
O M
OM
Roelfsema
F
F
Pereira
A M
AM
D000328:Adult; D000367:Age Factors; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005215:Fasting / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D019382:Human Growth Hormone / Q000172:deficiency / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D012737:Sex Factors; D016896:Treatment Outcome
D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D011994:Recombinant Proteins; D019382:Human Growth Hormone; D002784:Cholesterol