Resting metabolic rate, body composition and related hormonal parameters in growth hormone-deficient adults before and after growth hormone replacement therapy

Abstract

The resting metabolic rate (RMR), and body composition were assessed in 30 growth hormone-deficient (GHD) adults before and after 3 and 6 months of replacement therapy with recombinant human growth hormone (rhGH). In addition, insulin-like growth factor I (IGF-I), IGF binding proteins (IGFBPs) and plasma insulin were measured at baseline and at 6 months in relation to RMR. During 6 months of rhGH replacement therapy, body fat decreased from 18.2 +/- 1.5 (mean +/- SEM) to 14.3 +/- 1.6 kg (p < 0.0001), whereas fat-free mass (FFM) increased from 53.5 +/- 3.3 to 56.3 +/- 3.6 kg (p < 0.0001), RMR increased from 1246 +/- 92 to 1539 +/- 102 kcal/24 h (p < 0.0001) and RMR per kilogram of FFM increased from 23.2 +/- 0.6 to 27.4 +/- 0.5 (p < 0.0001). When RMR data were adjusted for the differences in FFM, it appeared that apart from the increase in FFM, other factors may play a role in the increase in RMR. During rhGH replacement therapy, IGF-I (p < 0.0001) and IGFBP-3 (p = 0.003) levels increased, whereas IGFBP-1 levels decreased significantly (p = 0.004). The FFM explained for about 80% of the variance in RMR. In addition, waist/hip ratio and plasma IGF-I contributed significantly to the explained variance of RMR. This study shows that in GHD adults FFM is the main determinant of RMR and that, next to the increase in FFM, changes in metabolic and hormonal parameters contribute to the increase in RMR during rhGH replacement therapy.

Metabolic effects of biosynthetic growth hormone treatment in severely energy-restricted obese women

“…GH treatment has been found to increase REE in adult patients with GH de®ciency. 15,30,31 In one study 15 the increase in REE was positively correlated with the increase in T3 serum levels, caused by the GH-induced peripheral conversion of T4 to T3 itself. A signi®cant increase in REE, recognizable even when REE was corrected for LBM and not correlated with thyroid hormone concentrations, was also observed in obese women treated with rhGH for ®ve weeks but not following a hypocaloric diet.…”

THERAPY IN ENDOCRINE DISEASE: Body composition and quality of life in adults treated with GH therapy: a systematic review and meta-analysis

“…Various investigators demonstrated that fat mass was higher by around 7% in GHD patients compared with age, sex and height adjusted predicted values (5,19,20). Reduction in fat mass after GH replacement therapy has been described mostly in the visceral fat mass using anthropometric measurements and imaging (17,19,21).…”

Priobretennaya nedostatochnost' gormona rosta u vzroslykh: etiologiya, klinicheskie proyavleniya, diagnostika i vozmozhnosti lecheniya

“…Назначение терапии ГР взрослым больным с приоб-ретенной СТГН приводит к уменьшению жировой массы с ее перераспределением из центральных в перифериче-ские депо, увеличению тощей массы, общего количества воды (при практически неизменной общей массе тела), что обусловлено анаболическим, липолитическим и ан-тинатрийуретическим действием СТГ [26,27].…”