Administration of recombinant human growth hormone normalizes GH-IGF1 axis and improves malnutrition-related disorders in patients with anorexia nervosa.
High serum level of GH in the presence of low plasma level of insulin-like growth factor-I (IGF-I) is one of the endocrinological features of anorexia nervosa (AN). Whether the amount of endogenous GH is not enough to increase IGF-I is not certain. We studied the effect of recombinant human growth hormone (rhGH) on the GH-IGF-I axis and on malnutrition-related disorders in this syndrome. Twenty patients with AN were divided into two groups; one (N = 13) was given rhGH (0.33 mg/day), and the other (N = 7) was given placebo for 6 or 12 months, respectively. During each treatment, levels of serum GH, plasma IGF-I, serum thyroid hormones, serum cholesterol, fasting plasma glucose and cardiac function were monitored. Changes in body mass index (BMI) and calorie taken were also evaluated. Plasma IGF-I level increased from 74.4 +/- 41.9 to 269.0 +/- 31.2 microg/L (P<0.001) during administration of rhGH, which associated with a decrease in serum GH level from 17.0 +/- 15.0 to 1.6 +/- 0.8 microg/L (P<0.001). Administration of rhGH increased BMI, body temperature, fasting plasma glucose level, and food intake. Serum level of triiodothyronine, but not thyroxine, increased during treatment with rhGH. The treatment decreased serum levels of both total and HDL-cholesterol. Studies with echocardiography showed an increase in cardiac output during the treatment with rhGH. These improvements were not observed in patients treated with placebo. Administration of rhGH is recommended as one of the methods of managing the patients with AN.
Hashizume
Kiyoshi
K
Department of Aging Medicine and Geriatrics, Institute on Aging and Adaptation, Shinshu University Graduate School of Medicine, Japan.
Suzuki
Satoru
S
Komatsu
Ai
A
Hiramatsu
Kunihide
K
Mori
Jun-Ichiro
J
Yamazaki
Masanori
M
Takeda
Teiji
T
Kakizawa
Tomoko
T
Miyamoto
Takahide
T
Koizumi
Yoichi
Y
Ichikawa
Kazuo
K
D000328:Adult; D000856:Anorexia Nervosa / Q000150:complications* / Q000523:psychology; D001290:Attitude; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D001831:Body Temperature / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D002784:Cholesterol / Q000097:blood; D002149:Energy Intake / Q000187:drug effects; D005260:Female; D019382:Human Growth Hormone / Q000008:administration & dosage / Q000378:metabolism* / Q000627:therapeutic use*; D006801:Humans; D007279:Injections, Subcutaneous; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D044342:Malnutrition / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism* / Q000473:pathology; D010976:Platelet Count; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D013963:Thyroid Hormones / Q000097:blood; D016896:Treatment Outcome
D001786:Blood Glucose; D011994:Recombinant Proteins; D013963:Thyroid Hormones; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D002784:Cholesterol