title: Relationship of peak growth hormone to cardiovascular parameters, waist circumference, lipids and glucose in HIV-infected patients and healthy adults.
abstract: OBJECTIVE
  Relative growth hormone (GH) deficiency is highly prevalent in patients with HIV. The purpose of this study was to investigate relationships of GH to metabolic and anthropometric parameters in HIV patients and non-HIV controls.
  
  
  METHODS
  Peak GH and metabolic parameters were assessed in a cross-sectional study of 191 HIV patients and 62 age and BMI-matched healthy controls.
  
  
  METHODS
  Peak GH was assessed by GHRH/arginine stimulation testing.
  
  
  RESULTS
  HIV patients demonstrated similar BMI, but increased waist circumference (WC) and reduced peak GH to GHRH/arginine compared with control subjects [median = 12.4 (interquartile range: 6.3-24.8) vs. 21.3 (8.8, 34.5) μg/l, P = 0.006, HIV vs. control]. Among HIV and non-HIV groups, peak GH was inversely associated with WC (rho = -0.44, P < 0.0001; rho = -0.63, P < 0.0001; HIV patients and controls, respectively), blood pressure (rho = -0.17, P = 0.02; rho = -0.36, P = 0.004), triglycerides (rho = -0.37, P < 0.0001; rho = -0.43, P = 0.001), glucose (rho = -0.34, P < 0.0001; rho = -0.30, P = 0.02), insulin (rho = -0.43, P < 0.0001; rho = -0.60, P < 0.0001) and CRP (rho= -0.29, P < 0.0001; rho = -0.59, P < 0.0001). Among HIV patients, the inverse association between peak GH and fasting glucose remained significant (β = -0.006 mmol/l change in glucose per μg/l change in GH, P = 0.004) controlling for age, gender, race, BMI, WC, protease inhibitor (PI) and nucleoside reverse transcriptase inhibitors. Similarly, the inverse association between peak GH and triglycerides remained significant (β = -0.01 mmol/l change in triglycerides per μg/l change in GH, P = 0.02) controlling for age, gender, race, BMI, WC, PI and lipid-lowering medications. HIV men with peak GH < 7.5 μg/l demonstrated higher BMI, WC, SBP, triglycerides, glucose and CRP.
  
  
  CONCLUSIONS
  Reduced GH secretion is independently associated with dyslipidaemia and higher glucose, among HIV patients with abdominal fat accumulation.
authors.affiliation: Massachusetts General Hospital, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA. jlo@partners.org
authors.forename: Janet
authors.initials: J
authors.lastname: Lo
authors.forename: Sung M
authors.initials: SM
authors.lastname: You
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Wei
authors.forename: Bridget
authors.initials: B
authors.lastname: Canavan
authors.forename: Steven
authors.initials: S
authors.lastname: Grinspoon
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000097:blood*; D019382:Human Growth Hormone / Q000097:blood*; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference / Q000502:physiology
chemical_list: D001786:Blood Glucose; D008055:Lipids; D014280:Triglycerides; D019382:Human Growth Hormone