The effects of GH replacement in adult GH‐deficient patients: changes in body composition without concomitant changes in the adipokines and insulin resistance

Hána, Václav; Silha, Josef V.; Justová, V; Lacinová, Z; Stepan, Jan J.; Murphy, Liam

doi:10.1111/j.1365-2265.2004.02000.x

Cited by 58 publications

(66 citation statements)

References 67 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The favourable effects of GH replacement were independent of the parameters of obesity and can thus be considered as self-determining. This finding supports previous findings from the literature (29,30), although it conflicts with some other data (23,24). Moreover, administration of GH changed all studied variables in a similar way in nearly all groups, suggesting that the favourable response to GH was maintained independent of the presence or degree of obesity.…”

Section: Discussioncontrasting

confidence: 47%

GH replacement in hypopituitarism improves lipid profile and quality of life independently of changes in obesity variables

Abrams

Boquete²,

Fideleff³

et al. 2008

European Journal of Endocrinology

View full text Add to dashboard Cite

Objective: GH deficiency (GHD) in adults is characterized by elevated body mass index (BMI), increased waist girth (WG) and increased fat mass (FM). Information about how these indicators of obesity affect the lipid profile and quality of life (QoL) of GHD subjects is scarce. It is also unclear how changes in these indicators brought about by GH replacement influence lipids and QoL. , WG (nZ508 with normal WG, nZ434 with increased WG) and FM (nZ357) and according to changes in these variables after 1 year of GH replacement. Serum IGF-I concentrations, lipid concentrations and QoL using the QoL Assessment of GHD in Adults questionnaire were assessed at baseline and after 1 year of treatment. Results: At baseline, total and low-density lipoprotein (LDL) cholesterol were similarly elevated in the BMI and WG groups, but high-density lipoprotein (HDL) cholesterol decreased and triglycerides increased with increasing BMI and WG. QoL was progressively poorer with increasing BMI and WG. After 1 year of GH replacement, total and LDL cholesterol and QoL improved in all BMI, WG and FM groups. Conclusions: Variables of obesity adversely affect the already unfavourable lipid profile in GHD subjects by decreasing HDL cholesterol, but do not counteract the positive effect of GH replacement on LDL cholesterol. Similarly, QoL is influenced by obesity, but responds equally well to GH treatment independent of BMI, WG and FM.European Journal of Endocrinology 159 825-832

show abstract

Section: Discussioncontrasting

confidence: 47%

GH replacement in hypopituitarism improves lipid profile and quality of life independently of changes in obesity variables

Abrams

Boquete²,

Fideleff³

et al. 2008

European Journal of Endocrinology

View full text Add to dashboard Cite

show abstract

“…In support of this, Hana et al found an increase in lean and a decrease in fat mass in 17 patients with GHD treated over 1 year, without a concomitant change in adipokines and insulin resistance (53). Opposite to this, a randomised, double-blind, placebo-controlled multicentre study of 166 patients with GHD treated over 1 year also found a decrease in fat and increase in lean body mass, but in this case with a concomitant reduction in total and LDL-cholesterol (54).…”

Section: Discussionmentioning

confidence: 69%

Determinants of cardiovascular risk in 2589 hypopituitary GH-deficient adults – a KIMS database analysis

et al. 2006

View full text Add to dashboard Cite

Objective: The aim of the present study was to clarify the relationship between GH deficiency (GHD) and some cardiovascular risk factors and to analyse the effect of GH replacement therapy in a large number of patients over a prolonged period of time. Design: Data for analysis were retrieved from KIMS (Pfizer International Metabolic Database). Serum concentrations of total cholesterol, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol and triglycerides were obtained from 2589 patients at baseline and from 1206 patients after 1 and 2 years of GH replacement therapy. Body mass index (BMI), waist and hip, resting blood pressure and body composition were also measured. Results: At baseline, the unfavourable effects of GHD were most obvious in the lipid profile demonstrating elevated mean total and LDL-cholesterol, in the increased waist circumference and the elevated BMI. The cholesterol concentration, BMI and body composition were significantly adversely affected by a number of factors, including age, sex and the use of anti-epileptic drugs. The therapeutic effect of GH was essentially uniform across the whole population. GH replacement reduced significantly the mean total and LDL-cholesterol, the waist circumference and the fat mass and was maintained during 2 years. Conclusions: This analysis of a large number of patients confirmed that GHD adults present with an increased cardiovascular risk. The sustained improvement of the adverse lipid profile and body composition suggests that GH replacement therapy may reduce the risk of cardiovascular disease and the premature mortality seen in hypopituitary patients with untreated GHD.European Journal of Endocrinology 155 79-90

show abstract

“…Cardiovascular risk factors described in this population include altered body composition with truncal adiposity, detrimental changes in lipid profile, insulin resistance and impaired exercise capacity, among others (1)(2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

Effects of GH treatment in GH-deficient adults on adiponectin, leptin and pregnancy-associated plasma protein-A.

Joaquín

Aguilera²,

Granada³

et al. 2008

European Journal of Endocrinology

View full text Add to dashboard Cite

Objective: GH deficiency (GHD) in adults is associated with adverse effects on metabolism and increased cardiovascular risk. Pregnancy-associated plasma protein-A (PAPP-A) is a protease that promotes IGF-I availability in vascular tissues. PAPP-A levels appear to correlate with carotid intima-media thickness and have been proposed as an early predictor of cardiac events. The aim of our study was to evaluate PAPP-A levels in GHD adults at baseline and after GH replacement and correlate them with changes in body composition, lipid profile, glucose homeostasis, inflammatory markers and in leptin and adiponectin. Patients and methods: Fourteen GHD adults were evaluated at baseline and after 1 year of GH therapy. All patients were compared at baseline with 28 age-, sex-and body mass index (BMI)-matched control subjects. Results: At baseline, GHD adults showed higher PAPP-A levels (PZ0.03) and higher leptin (PZ0.04), fibrinogen (PZ0.002) and highly sensitive C-reactive protein (PZ0.01) values than controls. Therapy with GH reduced PAPP-A (PZ0.03) and fibrinogen levels (PZ0.002) while increased BMI (PZ0.01) and reduced waist-hip ratio (WHR; PZ0.05) were observed. Insulin and homeostasis model assessment of insulin resistance index increased after treatment (P!0.004/PZ0.007), without changes in leptin or adiponectin levels. PAPP-A values correlated positively with BMI and WHR and negatively with adiponectin before and after treatment, with no correlation with glucose homeostasis parameters, lipid profile or leptin. Conclusions: Our study suggests that PAPP-A expression is increased in GHD adults, and that 1 year of GH replacement therapy is able to reduce PAPP-A levels in this population. However, further studies are required to determine whether this decrease correlates with an improvement in atherosclerosis.European Journal of Endocrinology 158 483-490

show abstract

The effects of GH replacement in adult GH‐deficient patients: changes in body composition without concomitant changes in the adipokines and insulin resistance

Cited by 58 publications

References 67 publications

GH replacement in hypopituitarism improves lipid profile and quality of life independently of changes in obesity variables

GH replacement in hypopituitarism improves lipid profile and quality of life independently of changes in obesity variables

Determinants of cardiovascular risk in 2589 hypopituitary GH-deficient adults – a KIMS database analysis

Effects of GH treatment in GH-deficient adults on adiponectin, leptin and pregnancy-associated plasma protein-A.

Contact Info

Product

Resources

About