Effects of recombinant human growth hormone in anorexia nervosa: a randomized, placebo-controlled study.

Abstract

CONTEXT:

Anorexia nervosa (AN), a state of chronic nutritional deprivation, is characterized by GH resistance with elevated GH levels and decreased levels of IGF-I. The effects of supraphysiological recombinant human GH (rhGH) on GH resistance in AN are not currently known.

OBJECTIVE:

The aim was to investigate whether supraphysiological rhGH increases IGF-I levels in AN.

DESIGN AND SETTING:

We conducted a randomized, placebo-controlled study in a Clinical Research Center.

PATIENTS:

We studied 21 women with AN, 10 (mean age, 28 ± 2.1 yr) treated with rhGH and 11 (mean age, 29.2 ± 2.6 yr) treated with placebo.

INTERVENTIONS:

rhGH (mean maximum daily dose, 1.4 ± 0.12 mg/d) or placebo was administered to patients for 12 wk.

MAIN OUTCOME MEASURES:

IGF-I, N-terminal propeptide of type 1 procollagen, type I collagen C-telopeptide, glucose, and insulin levels were measured at wk 0, 1, 2, 3, 4, 8, and 12; C-terminal propeptide of type 1 procollagen, leptin, and free fatty acid levels were measured at wk 0 and 12. Body composition, including total fat and lean mass, was measured by dual-energy x-ray absorptiometry at wk 0 and 12.

RESULTS:

IGF-I levels did not differ between the groups at baseline or after treatment (median after 12 wk-rhGH, 124 ng/ml, interquartile range, 94.5, 170.3; vs. placebo, 85.5 ng/ml, interquartile range, 62, 139; P = 0.3). Similarly, changes in glucose, insulin, free fatty acids, and bone markers did not differ between the groups. Total fat mass and percentage fat mass (rhGH, -2.5 ± 0.6%, vs. placebo, 2.2 ± 1.1%; P = 0.004) decreased significantly in the rhGH group compared to placebo despite comparable weight.

CONCLUSIONS:

Supraphysiological rhGH administration decreases fat mass in AN without increasing IGF-I levels, supporting the role of GH as a mediator of lipolysis independent of IGF-I.

• Authors: Pouneh K Fazeli, Elizabeth A Lawson, Rajani Prabhakaran, Karen K Miller, Daniel A Donoho, David R Clemmons, David B Herzog, Madhusmita Misra, Anne Klibanski
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 95 Issue 11 Pg. 4889-97 (Nov 2010) ISSN: 1945-7197 [Electronic] United States
• PMID: 20668047 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Blood Glucose
• Collagen Type I
• Insulin
• Leptin
• Recombinant Proteins
• Human Growth Hormone
• Insulin-Like Growth Factor I

Topics

• Absorptiometry, Photon
• Adult
• Analysis of Variance
• Anorexia Nervosa (blood, therapy)
• Blood Glucose (metabolism)
• Body Composition
• Collagen Type I (blood)
• Female
• Human Growth Hormone (therapeutic use)
• Humans
• Insulin (blood)
• Insulin-Like Growth Factor I (metabolism)
• Leptin (blood)
• Radioimmunoassay
• Recombinant Proteins (therapeutic use)
• Treatment Outcome