In a double-blind, placebo-controlled trial, we studied the effects of six months of growth hormone replacement in 24 adults with growth hormone deficiency. Most of the patients had acquired growth hormone deficiency during adulthood as a consequence of treatment for pituitary tumors, and all were receiving appropriate thyroid, adrenal, and gonadal hormone replacement. The daily dose of recombinant human growth hormone (rhGH) was 0.07 U per kilogram of body weight, given subcutaneously at bedtime. The mean (+/- SE) plasma concentration of insulin-like growth factor I increased from 0.41 +/- 0.05 to 1.53 +/- 0.16 U per liter during rhGH treatment. Treatment with rhGH had no effect on body weight. The mean lean body mass, however, increased by 5.5 +/- 1.1 kg (P less than 0.0001), and the fat mass decreased by 5.7 +/- 0.9 kg (P less than 0.0001) in the group treated with growth hormone; neither changed significantly in the placebo group. The basal metabolic rate, measured at base line and after one and six months of rhGH administration, increased significantly; the respective values were 32.4 +/- 1.4, 37.2 +/- 2.2, and 34.4 +/- 1.6 kcal per kilogram of lean body mass per day (P less than 0.001 for both comparisons). Fasting plasma cholesterol levels were lower (P less than 0.05) in the rhGH-treated group than in the placebo group, whereas plasma triglyceride values were similar in the two groups throughout the study. We conclude that growth hormone has a role in the regulation of body composition in adults, probably through its anabolic and lipolytic actions.
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Division of Medicine, United Medical and Dental Schools of Guy's and St. Thomas', St. Thomas' Hospital, London, United Kingdom.
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(2003). An AOA Critical Issue: Aging of the North American Population: New Challenges for Orthopaedics. JBJS
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Ozata, M., Dieguez, C., Casanueva, F. F.
(2003). The Inhibition of Growth Hormone Secretion Presented in Obesity Is Not Mediated by the High Leptin Levels: A Study in Human Leptin Deficiency Patients. J. Clin. Endocrinol. Metab.
88: 312-316
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Buijs, M. M., Romijn, J. A., Burggraaf, J., de Kam, M. L., Cohen, A. F., Frolich, M., Stellaard, F., Meinders, A. E., Pijl, H.
(2002). Growth Hormone Blunts Protein Oxidation and Promotes Protein Turnover to a Similar Extent in Abdominally Obese and Normal-Weight Women. J. Clin. Endocrinol. Metab.
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Liu, Z., Barrett, E. J.
(2002). Human protein metabolism: its measurement and regulation. Am. J. Physiol. Endocrinol. Metab.
283: E1105-E1112
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Frick, F., Linden, D., Ameen, C., Eden, S., Mode, A., Oscarsson, J.
(2002). Interaction between growth hormone and insulin in the regulation of lipoprotein metabolism in the rat. Am. J. Physiol. Endocrinol. Metab.
283: E1023-E1031
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Murray, R. D., Shalet, S. M.
(2002). Adult Growth Hormone Replacement: Lessons Learned and Future Direction. J. Clin. Endocrinol. Metab.
87: 4427-4428
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Isley, W. L.
(2002). Growth Hormone Therapy for Adults: Not Ready for Prime Time?. ANN INTERN MED
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Buijs, M. M., Burggraaf, J., Langendonk, J. G., Schoemaker, R. C., Frolich, M., Arndt, J.-W., Cohen, A. F., Romijn, J. A., Ackermans, M. T., Sauerwein, H. P., Meinders, A. E., Pijl, H.
(2002). Hyposomatotropism Blunts Lipolysis in Abdominally Obese Women. J. Clin. Endocrinol. Metab.
87: 3851-3858
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Ezzat, S., Fear, S., Gaillard, R.-C., Gayle, C., Landy, H., Marcovitz, S., Mattioni, T., Nussey, S., Rees, A., Svanberg, E.
(2002). Gender-Specific Responses of Lean Body Composition and Non-Gender-Specific Cardiac Function Improvement after GH Replacement in GH-Deficient Adults. J. Clin. Endocrinol. Metab.
87: 2725-2733
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Wallace, J. D., Abbott-Johnson, W. J., Crawford, D. H. G., Barnard, R., Potter, J. M., Cuneo, R. C.
(2002). GH Treatment in Adults with Chronic Liver Disease: A Randomized, Double-Blind, Placebo-Controlled, Cross-Over Study. J. Clin. Endocrinol. Metab.
87: 2751-2759
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Porretti, S., Giavoli, C., Ronchi, C., Lombardi, G., Zaccaria, M., Valle, D., Arosio, M., Beck-Peccoz, P.
(2002). Recombinant Human GH Replacement Therapy and Thyroid Function in a Large Group of Adult GH-Deficient Patients: When Does L-T4 Therapy Become Mandatory?. J. Clin. Endocrinol. Metab.
87: 2042-2045
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Tschop, M., Statnick, M. A., Suter, T. M., Heiman, M. L.
(2002). GH-Releasing Peptide-2 Increases Fat Mass in Mice Lacking NPY: Indication for a Crucial Mediating Role of Hypothalamic Agouti-Related Protein. Endocrinology
143: 558-568
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Segerlantz, M., Bramnert, M., Manhem, P., Laurila, E., Groop, L. C.
(2001). Inhibition of the Rise in FFA by Acipimox Partially Prevents GH-Induced Insulin Resistance in GH-Deficient Adults. J. Clin. Endocrinol. Metab.
86: 5813-5818
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Wolthers, T., Hoffman, D. M., Nugent, A. G., Duncan, M. W, Umpleby, M., Ho, K. K. Y.
(2001). Oral estrogen antagonizes the metabolic actions of growth hormone in growth hormone-deficient women. Am. J. Physiol. Endocrinol. Metab.
281: E1191-E1196
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Muller, A. F., Leebeek, F. W. G., Janssen, J. A. M. J. L., Lamberts, S. W. J., Hofland, L., van der Lely, A. J.
(2001). Acute Effect of Pegvisomant on Cardiovascular Risk Markers in Healthy Men: Implications for the Pathogenesis of Atherosclerosis in GH Deficiency. J. Clin. Endocrinol. Metab.
86: 5165-5171
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Hernberg-Stahl, E., Luger, A., Abs, R., Bengtsson, B.-A., Feldt-Rasmussen, U., Wilton, P., Westberg, B., Monson, J. P.
(2001). Healthcare Consumption Decreases in Parallel with Improvements in Quality of Life during GH Replacement in Hypopituitary Adults with GH Deficiency. J. Clin. Endocrinol. Metab.
86: 5277-5281
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McConnell, E. M., Atkinson, A. B., Ennis, C., Hadden, D. R., McCance, D. R., Sheridan, B., Bell, P. M.
(2001). The Effects on Insulin Action in Adult Hypopituitarism of Recombinant Human GH Therapy Individually Titrated for Six Months. J. Clin. Endocrinol. Metab.
86: 5342-5347
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O'Sullivan, A. J., Martin, A., Brown, M. A.
(2001). Efficient Fat Storage in Premenopausal Women and in Early Pregnancy: A Role for Estrogen. J. Clin. Endocrinol. Metab.
86: 4951-4956
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Span, J. P. T., Pieters, G. F. F. M., Sweep, F. G. J., Hermus, A. R. M. M., Smals, A. G. H.
(2001). Gender Differences in rhGH-Induced Changes in Body Composition in GH-Deficient Adults. J. Clin. Endocrinol. Metab.
86: 4161-4165
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