Low-dose growth hormone and human immunodeficiency virus-associated lipodystrophy syndrome: a pilot study.

Abstract

BACKGROUND:

Treatment with high doses (2-6 mg day(-1)) of human growth hormone (hGH) in patients with human immunodeficiency virus (HIV)-associated lipodystrophy syndrome (HALS) has been shown to increase concentrations of total insulin-like growth-factor-I (IGF-I) more than twofold greater than the normal upper range and is accompanied by adverse effects such as joint pain and glucose intolerance.

MATERIALS AND METHODS:

We performed a 16-week open-labelled prospective pilot study in six male HALS patients using a s.c. low-dose hGH, 0.7 mg day(-1), aiming to examine the impact on total and free IGF-I and fat distribution. Glucose metabolism was examined by oral glucose tolerance tests and hyperinsulinaemic euglycaemic clamps.

RESULTS:

Total IGF-I increased twofold (P < 0.01) and free IGF-I increased 2.5-fold (P < 0.01) to the level of the normal upper range. HDL-cholesterol increased (P = 0.01). Patients reported improvements of lipodystrophy, which was supported by a decreased waist-to-thigh ratio (P = 0.01), and waist-to-hip ratio (P = 0.06). Ratio of peripheral to trunk soft tissue mass increased (P = 0.01, measured by dual-energy X-ray absorptiometry scans) and a trend towards reduction in percentage of trunk fat was suggested (P = 0.12). Total fat mass, exercise capacity, glucose tolerance, glucose disposal rate and immune status, respectively, did not change (all P > 0.5). The patients did not complain of arthralgia or other known GH-related side-effects.

CONCLUSIONS:

Sixteen weeks' treatment of lipodystrophic HIV-infected patients with hGH, 0.7 mg day(-1), increased total and free IGF-I twofold and appeared safe and tolerable. The potential of low-dose hGH in the treatment of HIV-lipodystrophy awaits examination by placebo-controlled, randomized trials.

• Authors: O Andersen, S B Haugaard, A Flyvbjerg, U B Andersen, H Ørskov, S Madsbad, J O Nielsen, J Iversen
• Journal: European journal of clinical investigation (Eur J Clin Invest) Vol. 34 Issue 8 Pg. 561-8 (Aug 2004) ISSN: 0014-2972 [Print] England
• PMID: 15305891 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright 2004 Blackwell Publishing Ltd

Chemical References

• Blood Glucose
• Human Growth Hormone
• Insulin-Like Growth Factor I

Topics

• Adult
• Antiretroviral Therapy, Highly Active
• Blood Glucose (metabolism)
• Body Composition
• Diet
• Energy Intake
• Glucose Tolerance Test
• HIV-Associated Lipodystrophy Syndrome (drug therapy, metabolism)
• Human Growth Hormone (administration & dosage)
• Humans
• Insulin-Like Growth Factor I (metabolism)
• Male
• Middle Aged
• Pilot Projects
• Prospective Studies