Growth hormone decreases visceral fat and improves cardiovascular risk markers in women with hypopituitarism: a randomized, placebo-controlled study.

Abstract

CONTEXT:

Data regarding gender-specific efficacy of GH on critical endpoints are lacking. There are no randomized, placebo-controlled studies of physiological GH therapy solely in women.

OBJECTIVE:

Our objective was to determine the effects of physiological GH replacement on cardiovascular risk markers and body composition in women with GH deficiency (GHD).

DESIGN:

This was a 6-month, randomized, placebo-controlled, double-blind study.

SETTING:

The study was conducted at the General Clinical Research Center.

STUDY PARTICIPANTS:

43 women with GHD due to hypopituitarism were included in the study.

INTERVENTION:

Study participants were randomized to receive GH (goal mid-normal serum IGF-1) or placebo.

MAIN OUTCOME MEASURES:

Cardiovascular risk markers, including high-sensitivity C-reactive protein, tissue plasminogen activator, and body composition, including visceral adipose tissue by cross-sectional computed tomography, were measured.

RESULTS:

Mean daily GH dose was 0.67 mg. The mean IGF-1 sd score increased from -2.5 +/- 0.3 to -1.4 +/- 0.9 (GH) (P < 0.0001 vs. placebo). High-sensitivity C-reactive protein decreased by 38.2 +/- 9.6% (GH) vs.18.2 +/- 6.0% (placebo) (P = 0.03). Tissue plasminogen activator and total cholesterol decreased, and high-density lipoprotein increased. Homeostasis model assessment-insulin resistance and other markers were unchanged. Body fat decreased [-5.1 +/- 2.0 (GH) vs. 1.9 +/- 1.0% (placebo); P = 0.002] as did visceral adipose tissue [-9.0 +/- 5.9 (GH) vs. 4.3 +/- 2.7% (placebo); P = 0.03]. Change in IGF-1 level was inversely associated with percent change in visceral adipose tissue (r = -0.61; P = 0.002), total body fat (r = -0.69; P < 0.0001), and high-sensitivity C-reactive protein (r = -0.51; P = 0.003).

CONCLUSIONS:

Low-dose GH replacement in women with GHD decreased total and visceral adipose tissue and improved cardiovascular markers, with a relatively modest increase in IGF-1 levels and without worsening insulin resistance.

• Authors: Catherine Beauregard, Andrea L Utz, Amber E Schaub, Lisa Nachtigall, Beverly M K Biller, Karen K Miller, Anne Klibanski
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 93 Issue 6 Pg. 2063-71 (Jun 2008) ISSN: 0021-972X [Print] United States
• PMID: 18381581 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• Lipids
• Lipoproteins
• Placebos
• Human Growth Hormone
• Insulin-Like Growth Factor I
• Growth Hormone
• Glucose

Topics

• Adult
• Aged
• Biomarkers (blood, metabolism)
• Body Composition (drug effects)
• Cardiovascular Diseases (blood, etiology, metabolism)
• Double-Blind Method
• Female
• Glucose (metabolism)
• Growth Hormone (deficiency)
• Human Growth Hormone (adverse effects, pharmacology, therapeutic use)
• Humans
• Hypopituitarism (blood, drug therapy, metabolism, pathology)
• Insulin-Like Growth Factor I (analysis)
• Intra-Abdominal Fat (drug effects, pathology)
• Lipids (blood)
• Lipoproteins (blood)
• Middle Aged
• Placebos
• Risk Factors