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Growth hormone (GH)-deficient men are more responsive to GH replacement therapy than women
P Burman1, A G Johansson, A Siegbahn
1Department of Medicine, Clinical Chemistry, University Hospital, Uppsala, Sweden.
Insights
Men and women with growth hormone deficiency (GHD) respond differently to recombinant growth hormone (GH) therapy. Men experienced greater improvements in body composition and cardiovascular risk factors compared to women.
Area of Science:
- Endocrinology
- Metabolism
- Clinical Research
Background:
- Adult-onset growth hormone deficiency (GHD) affects body composition and metabolic parameters.
- Gender-based differences in GHD and its treatment response are not fully understood.
Purpose of the Study:
- To evaluate gender-specific effects of recombinant human growth hormone (rhGH) replacement therapy in adult GHD patients.
- To compare the impact of rhGH on body composition, biochemical markers, and bone metabolism between men and women.
Main Methods:
- Double-blind, placebo-controlled, cross-over trial over 21 months.
- 36 adult GHD patients (21 men, 15 women) received rhGH (dose adjusted for body surface area).
- Evaluated changes in body composition, serum insulin-like growth factor I (IGF-I), lipids, and bone markers.
Main Results:
- Men had higher baseline IGF-I, lower body fat, and greater lean mass than women.
- rhGH increased IGF-I more in men than women.
- Men showed greater reductions in body fat, total cholesterol, LDL cholesterol, apolipoprotein B, and PAI-1.
- Bone formation and resorption markers increased more in men.
Conclusions:
- Adult GHD patients exhibit significant gender differences in response to rhGH therapy.
- Men demonstrate a more pronounced positive response in body composition and metabolic profiles.
- Treatment strategies for GHD should consider these gender-specific variations for optimal outcomes.
Abstract:
Thirty-six patients with adult-onset GH deficiency (GHD) were examined before and after 9 months of treatment with recombinant GH. The study was conducted as a double blind, placebo-controlled, 21-month trial with a cross-over design, with each treatment period lasting for 9 months. The same dose, adjusted for body surface area, was given to men (n = 21) and women (n = 15), and the effects on body composition and biochemical parameters were evaluated with respect to gender. The extent of GHD, assessed before therapy from basal GH secretion and GH release in response to provocative tests, did not differ between the two groups. The men, however, had higher serum insulin-like growth factor I concentrations than the women (mean +/- SD, 126 +/- 71 vs. 61 +/- 32 micrograms/L; P = 0.0003), less body fat, and greater lean body mass. Upon treatment, insulin-like growth factor I concentrations increased more in men than in women (by 305 +/- 136 and 198 +/- 96 micrograms/L, respectively; P = 0.02). The men lost more body fat than the women (7.4 +/- 4.1% vs. 3.3 +/- 3.8%; P = 0.002), whereas the difference in gain in lean body mass failed to reach statistical significance. Serum levels of total cholesterol, low density lipoprotein cholesterol, apolipoprotein B, and plasminogen activator inhibitor-1 decreased in the male group (P = 0.003, P = 0.03, P = 0.0009, and P = 0.01, respectively), but not in the females. Serum markers of bone formation, namely osteocalcin, procollagen type I, bone-specific alkaline phosphatase, and a marker of bone resorption, telopeptide of collagen type I, increased more markedly in men than in women. Lipoprotein(a) increased to a similar extent in the male and female groups. The data demonstrate that men and women with GHD display marked differences in their responsiveness to GH replacement therapy. These differences should be taken into consideration when optimizing the treatment of GHD patients.