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Effects of growth hormone treatment in obese prepubertal boys
1Department of Pediatrics, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden.
Insights
Growth hormone (GH) treatment in obese prepubertal boys reduced body fat by stimulating lipolysis. This study found positive effects on body composition and insulin secretion without impacting glucose homeostasis.
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
- Obesity Research
Background:
- Childhood obesity is linked to growth hormone (GH) axis dysfunction.
- GH treatment in adults improves body composition and metabolic profiles.
- The effects of GH on obese children remain largely uninvestigated.
Purpose of the Study:
- To evaluate the impact of GH treatment on body fat, insulin sensitivity, and lipolysis in prepubertal obese boys.
- To assess the safety and efficacy of GH in this specific pediatric population.
Main Methods:
- Seven severely obese prepubertal boys (aged 10-12) received GH treatment for 6 months.
- Body fat percentage, insulin secretion and sensitivity (via IVGTT), and adipocyte lipolysis were measured.
- No dietary or exercise interventions were implemented during the study.
Main Results:
- GH treatment significantly reduced body fat percentage (51.3% to 46.1%, P=0.03).
- Acute insulin secretion responsivity increased (P=0.04), with a trend towards improved insulin sensitivity.
- GH significantly increased catecholamine-induced lipolysis in adipocytes (2.5-fold, P=0.02) without affecting basal or insulin-stimulated lipogenesis.
Conclusions:
- Six months of GH treatment effectively reduces body fat in prepubertal obese boys.
- GH may act by enhancing catecholamine-induced lipolysis.
- GH treatment appears safe regarding glucose homeostasis in this cohort.
Abstract:
Childhood obesity is associated with several abnormalities of the GH axis, including decreased spontaneous secretion, decreased response to exogenous secretagogues, and altered pulsatile pattern of secretion. In adults, GH treatment reduces abdominal obesity and improves insulin sensitivity, as well as blood lipid profiles. Whether GH has similar effects in obese children has not been investigated previously. In this study, seven prepubertal severely obese boys aged 10-12 yr were treated with GH for 6 months and followed for an additional 6 months. No diet or exercise modifications were initiated. Body fat percentage decreased from 51.3% to 46.1% after treatment (P = 0.03). Frequently sampled iv glucose tolerance tests revealed an increased responsivity of the acute insulin secretion (P = 0.04) and a nonsignificant trend toward improved insulin sensitivity. In isolated adipocytes, the maximum isoprenaline- and terbutaline-induced lipolysis were increased approximately 2.5-fold (P = 0.02). The sensitivity of the adipocytes to isoprenaline was unchanged, whereas the sensitivity to terbutaline was increased (P = 0.04). No effect was observed on basal or insulin-stimulated lipogenesis. In conclusion, GH treatment for 6 months of obese prepubertal boys reduces body fat, possibly, via stimulation of catecholamine-induced lipolysis, without negative effects on glucose homeostasis.