title: GH response to GHRH plus arginine is impaired in lipoatrophic women with human immunodeficiency virus compared with controls.
abstract: OBJECTIVE
  GH secretion is impaired in lipodystrophic human immunodeficiency virus (HIV) patients and inversely related to lipodystrophy-related fat redistribution in men. Less is known about the underlying mechanisms involved in reduced GH secretion in HIV-infected women.
  
  
  METHODS
  A case-control, cross-sectional study comparing GH/IGF1 status, body composition, and metabolic parameters in 92 nonobese women with HIV-related lipodystrophy and 63 healthy controls matched for age, ethnicity, sex, and body mass index (BMI).
  
  
  METHODS
  GH, IGF1, IGF binding protein 3 (IGFBP3), GH after GHRH plus arginine (GHRH+Arg), several metabolic variables, and body composition were evaluated.
  
  
  RESULTS
  GH response to GHRH+Arg was lower in HIV-infected females than in controls. Using a cutoff of peak GH ≤ 7.5 μg/l, 20.6% of HIV-infected females demonstrated reduced peak GH response after GHRH+Arg. In contrast, none of the control subjects demonstrated a peak GH response ≤ 7.5 μg/l. Bone mineral density (BMD), quality of life, IGF1, and IGFBP3 were lowest in the HIV-infected females with a GH peak ≤ 7.5 μg/l. BMI was the main predictive factor of GH peak in stepwise multiregression analysis followed by age, with a less significant effect of visceral fat in the HIV-infected females.
  
  
  CONCLUSIONS
  This study establishes that i) GH response to GHRH+Arg is lower in lipoatrophic HIV-infected women than in healthy matched controls, ii) BMI more than visceral adipose tissue or trunk fat influences GH peak in this population, and iii) HIV-infected women with a GH peak below or equal to 7.5 μg/l demonstrate reduced IGF1, IGFBP3, BMD, and quality of life.
authors.affiliation: Integrated Department of Medicine, University of Modena and Reggio Emilia, Via Giardini 1355, 41100 Modena, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Zirilli
authors.forename: Gabriella
authors.initials: G
authors.lastname: Orlando
authors.forename: Federica
authors.initials: F
authors.lastname: Carli
authors.forename: Bruno
authors.initials: B
authors.lastname: Madeo
authors.forename: Stefania
authors.initials: S
authors.lastname: Cocchi
authors.forename: Chiara
authors.initials: C
authors.lastname: Diazzi
authors.forename: Cesare
authors.initials: C
authors.lastname: Carani
authors.forename: Giovanni
authors.initials: G
authors.lastname: Guaraldi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Rochira
mesh_terms: D000293:Adolescent; D000328:Adult; D001120:Arginine / Q000008:administration & dosage*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D013007:Growth Hormone-Releasing Hormone / Q000008:administration & dosage*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D015497:HIV-1 / Q000187:drug effects; D019382:Human Growth Hormone / Q000037:antagonists & inhibitors* / Q000096:biosynthesis*; D006801:Humans; D008060:Lipodystrophy / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D019382:Human Growth Hormone; D013007:Growth Hormone-Releasing Hormone; D001120:Arginine