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

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Summary background 

Growth hormone deficiency (GHD) in adult life has been associated with increased central adiposity, decreased insulin sensitivity, dyslipidaemia and increased risk of cardiovascular disease. The effects of GH replacement on adiponectin and resistin, adipokines which have a role in modulating insulin sensitivity have not been previously reported. aim 

To examine the effects of GH replacement on adipokine levels and insulin resistance in GHD patients. design 

Seventeen adult GHD patients were examined at baseline and after 1 year of treatment with recombinant human GH (mean dose 0·31 mg/day, range 0·13–0·67 mg/day). results 

GH replacement significantly increased IGF-I levels. The mean IGF-I SD score increased from − 1·98 at baseline to 0·76 at study end. GH replacement was associated with a significant reduction in percentage body fat (34·11 ± 1·33 vs. 30·65 ± 1·27%, P < 0·0005) and a significant increase in lean body mass (63·57 ± 1·24 vs. 66·96 ± 1·18%, P < 0·0004), before and after treatment, respectively. Surprisingly, there was no effect of GH replacement on the plasma levels of leptin, resistin or adiponectin or on plasma lipid profile. Insulin sensitivity did not deteriorate during GH replacement despite the known ‘anti-insulin’ effect of GH. Fasting glucose, insulin and insulin resistance as calculated using the homeostasis model assessment insulin resistance index (HOMA-R) were unchanged by GH treatment. conclusion 

These data demonstrate GH replacement in adult subjects with GHD is effective in changing body composition and restoring IGF-I levels over a 12-month period; however, in our study, these changes were not accompanied by changes in adipokine levels or beneficial effects on plasma lipids or insulin resistance.
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Document Type: Research Article

Affiliations: 1: Third Department of Internal Medicine, First Faculty of Medicine, Charles University, Prague, Czech Republic and 2: Departments of Physiology and

Publication date: April 1, 2004

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