title: Limited effects of growth hormone replacement in patients with GH deficiency during long-term cure of acromegaly.
abstract: The aim of this study was to assess the effects of replacement with recombinant human growth hormone (rhGH) in patients with GH deficiency (GHD) after treatment of acromegaly. Intervention study. Sixteen patients (8 men, age 56 years), treated for acromegaly by surgery and radiotherapy, with an insufficient GH response to insulin-induced hypoglycaemia, were treated with 1 year of rhGH replacement. Study parameters were assessed at baseline and after 1 year of rhGH replacement. Study parameters were cardiac function, body composition, bone mineral density (BMD), fasting lipids, glucose, bone turnover markers, and Quality of Life (QoL). During rhGH replacement IGF-I concentrations increased from -0.4 +/- 0.7 to 1.0 +/- 1.5 SD (P = 0.001), with a mean daily dose of 0.2 +/- 0.1 mg in men and 0.3 +/- 0.2 mg in women. Nonetheless, rhGH replacement did not alter cardiac function, lipid and glucose concentrations, body composition or QoL. Bone turnover markers (PINP and beta crosslaps) levels increased (P = 0.005 and P = 0.021, respectively), paralleled by a small, but significant decrease in BMD of the hip. The beneficial effects of rhGH replacement in patients with GHD during cure from acromegaly are limited in this study.
authors.affiliation: Department of Endocrinology and Metabolic Diseases C4-R, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands. a.a.van_der_klaauw@lumc.nl
authors.forename: Agatha A
authors.initials: AA
authors.lastname: van der Klaauw
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Roelfsema
authors.forename: Marcel P M
authors.initials: MP
authors.lastname: Stokkel
authors.forename: Gabe B
authors.initials: GB
authors.lastname: Bleeker
authors.forename: Nienke R
authors.initials: NR
authors.lastname: Biermasz
authors.forename: Johannes W A
authors.initials: JW
authors.lastname: Smit
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Romijn
authors.forename: Alberto M
authors.initials: AM
authors.lastname: Pereira
mesh_terms: D000172:Acromegaly / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D000328:Adult; D000368:Aged; D001823:Body Composition / Q000187:drug effects; D015519:Bone Density / Q000187:drug effects; D005260:Female; D005947:Glucose / Q000378:metabolism; D006321:Heart / Q000187:drug effects; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000172:deficiency / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007018:Hypopituitarism / Q000188:drug therapy*; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D050356:Lipid Metabolism / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018972:Insulin-Like Growth Factor Binding Protein 3; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D005947:Glucose