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Published on: October 12, 2017
Moderate doses of hGH (0.64 mg/d) improve lipids but not cardiovascular function in GH-deficient adults with normal
Connie B Newman1, Katalin A Frisch, Barry Rosenzweig
1Division of Endocrinology, New York University School of Medicine, New York, New York 10016, USA.
Insights
Lower-dose growth hormone (GH) in adults with GH deficiency (GHD) did not improve exercise capacity but did lower cholesterol and increase lean body mass. Responses to GH therapy can vary, requiring careful monitoring.
Area of Science:
- Endocrinology
- Cardiopulmonary Physiology
- Metabolic Medicine
Background:
- Limited data exist on the effects of lower-dose growth hormone (GH) on cardiopulmonary function in adults with GH deficiency (GHD).
- Understanding these effects is crucial for optimizing treatment in this population.
Purpose of the Study:
- To assess the impact of lower-dose recombinant human GH on exercise capacity.
- To evaluate changes in echocardiographic parameters in GHD adults.
- To investigate effects on body composition and lipid profiles.
Main Methods:
- A 6-month, double-blind, placebo-controlled randomized trial involving 30 hypopituitary adults with GHD.
- Subjects received either recombinant human GH (mean dose 0.64 mg/d) or placebo.
- Primary endpoints included exercise duration, maximal oxygen consumption, and left ventricular ejection fraction; secondary endpoints covered echocardiographic indices, body composition, and lipids.
Main Results:
- GH treatment significantly increased insulin-like growth factor-I (IGF-I) levels.
- Total and LDL cholesterol levels were significantly reduced by GH therapy compared to placebo.
- While lean body mass increased and fat mass decreased, these changes were not statistically significant between groups. Exercise performance and echocardiographic parameters showed no significant changes.
Conclusions:
- Lower-dose GH therapy in GHD adults did not improve exercise performance or echocardiographic measures.
- Significant benefits included reductions in total and LDL cholesterol and increases in lean body mass and IGF-I.
- Individual responses to GH therapy can be variable, necessitating baseline and ongoing assessment during treatment.
Context:
Data regarding effects of lower-dose GH on cardiopulmonary function in GH-deficient (GHD) adults are limited.
Objectives:
The objective was to assess effects of lower-dose GH on exercise capacity and echocardiographic parameters in GHD adults.
Design:
The study was a 6-month double-blind, placebo-controlled randomized trial.
Setting:
The study was conducted at the General Clinical Research Center.
Participants:
Thirty hypopituitary adults with GHD were studied.
Intervention:
Subjects were randomized to recombinant human GH or placebo for 6 months, followed by open-label recombinant human GH for 12 months.
Main Outcome Measures:
Primary endpoints were exercise duration, maximal oxygen consumption, and left ventricular ejection fraction. Secondary endpoints were echocardiographic indices of systolic and diastolic function, left ventricular mass, lipids, and body composition.
Results:
In the 6-month double-blind phase, mean GH dose was 0.64 mg/d. Mean IGF-I sd score increased from -4.5 to -1.0. Exercise duration, maximal oxygen consumption, left ventricular ejection fraction, and other echocardiographic parameters were normal at baseline and did not change. GH decreased total and low-density lipoprotein cholesterol by 7.5% (P = 0.016) and 14.7% (P = 0.002) (P = 0.04 vs. placebo). Mean lean body mass increased by 2.2 kg (P = 0.004), fat mass decreased by 1.7 kg (P = 0.21), and percent body fat decreased by 2.5% (P = 0.018), although between-group changes were not significant.
Conclusions:
Human GH did not improve exercise performance or echocardiographic parameters or decrease fat mass but significantly decreased total and low-density lipoprotein cholesterol, increased IGF-I, and increased lean body mass. These results indicate that responses to human GH are variable and should be assessed at baseline and during treatment.
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