Growth Hormone (GH) Replacement Therapy in Adult-Onset GH Deficiency

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Endocrine Care – HGH, The Human Growth Hormone

Growth Hormone (GH) Replacement Therapy in Adult-Onset GH Deficiency: Effects on Body Composition in Men and Women in a Double-Blind, Randomized, Placebo-Controlled Trial

Adult GH Deficiency (AGHD) is characterized by an altered body composition, an atherogenic lipid profile, decreased exercise capacity, and diminished quality of life. We performed a randomized, double-blind, placebo-controlled, multicenter study in 166 subjects with AGHD to assess the effects of GH on these outcomes. GH was initiated at 0.0125 mg/kg·d, increased to 0.025 mg/kg·d as tolerated, or decreased to 0.00625 mg/kg·d for 12 months. Primary measures of efficacy included body composition, strength and endurance, and quality of life. Additional parameters included serum IGF-I concentrations, serum lipids, and bone mineral density.

After 12 months, 79% of subjects remained on GH 0.0125 mg/kg·d, whereas 21% received 0.00625 mg/kg·d. GH-treated men and women demonstrated significant decreases in total body and trunk fat and increases in lean body mass over baseline. In GH-treated men, mean IGF-I sd scores exceeded age-adjusted normal ranges, whereas similar doses produced a smaller response in women. GH treatment was associated with significant improvements in total cholesterol and low-density lipoprotein (P < 0.05 for all). No significant treatment effects were observed in strength and endurance, quality of life, or bone mineral density. GH treatment was generally well tolerated. Subjects with AGHD should receive individualized GH therapy to maintain IGF-I between the mean value and +2 sd and improve body composition and cardiovascular risk factors.

GH IS REQUIRED for normal growth and metabolic homeostasis in children. However, GH secretion occurs throughout life and is known to have profound effects on anabolism, lipolysis, and carbohydrate metabolism. Individuals who develop adult GH deficiency (AGHD) secondary to pituitary or hypothalamic disease exhibit abnormal body composition, characterized by a significant increase in fat mass, particularly visceral fat, and a decrease in lean body mass (1, 2, 3, 4, 5, 6). Many have diminished strength and exercise capacity that may improve with GH therapy (7, 8). Adults with AGHD also demonstrate altered lipid metabolism, increased incidence of cardiovascular disease, and diminished quality of life (9, 10, 11, 12). Reduced life expectancy secondary to increased cerebrovascular and cardiovascular disease has also been reported in patients with hypopituitarism (13). Adults with AGHD experience feelings of social isolation, decreased energy, and an overall poorer quality of life when compared with controls (11, 14, 15, 16). Bone mineral density (BMD) is also reduced in these subjects (6), resulting in a 3-fold increase in bone fracture rate (17).

Short-term GH replacement therapy in adults has been associated with beneficial effects on body composition, fat distribution, and quality of life (2, 18, 19). Improvements in bone mineral content and BMD are not apparent until GH has been administered for at least 18 months (20, 21). In general, studies of GH therapy in subjects with AGHD have been relatively small, nonrandomized, or uncontrolled. Moreover, potential differences in the ability of men and women to respond to GH have not been adequately examined in most of these studies.

This large multicenter, randomized, placebo-controlled study explored the effects of GH treatment on body composition and physical performance. The primary end points were a decrease in percentage of body fat, an increase in muscle strength, and improved quality of life. The anticipated reduction in cardiovascular risk emerged as the most compelling reason to examine the impact of GH replacement therapy in adults with GHD.

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Effects of Physiologic Growth Hormone Therapy on Bone Density and Body Composition in Patients with Adult-Onset Growth Hormone Deficiency

HGH Growth Hormone Medical Studies

HGH, Body Composition & Bone Density

A Randomized, Placebo-Controlled HGH Medical Trial

Howard B.A. Baum, MD; Beverly M.K. Biller, MD; Joel S. Finkelstein, MD;
Kristin Baker Cannistraro, BS, RN; Daniel S. Oppenheim, MD, PhD; David A. Schoenfeld, PhD; Theresa Hoskins Michel, PT, MS; Harriet Wittink, PT, MS; and Anne Klibanski, MD; 1 December 1996 | Volume 125 Issue 11 | Pages 883-890

HGH Study Background: Patients with adult-onset growth hormone deficiency have reduced bone density and increased fat mass. Growth hormone at high doses may decrease body fat in these patients, and while benefits to muscle mass and bone density exist, the full effects of growth hormone at more physiologic doses on bone density and body composition have are yet to be shown.

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Study Finds Hormone Therapy Helpful For Cystic Fibrosis

HGH helpful for Cystic Fibrosis

By William Weir, bweir@courant.com

Human growth hormone is a promising tool in treating cystic fibrosis, a new University of Connecticut study suggests.

Although HGH not a cure for the disease, which afflicts 30,000 people in the U.S., the researchers found that it reduced the number of hospitalizations among those who have the disease.

The study, published Monday in the journal Pediatrics, was produced by the UConn/Hartford Hospital Evidence-based Practice Center and was funded by the U.S. Department of Health and Human Services. Continue reading

Students organize Crohn’s Growth Foundation

Using HGH to fight Crohn’s Disease

By Chase Wade, Features Intern, cdwade@smu.edu

What started as a conversation between SMU juniors Sam Aronowitz and Stephen Poulin became a new foundation looking to change the way SMU views Crohn’s disease.

Both Aronowitz and Poulin have family members with the disease. Aronowitz said these family members are the ones who motivated them to start the Crohn’s Growth Foundation.

Considered a genetic disease by some medical professionals, Crohn’s disease involves the inflammation of the small and large intestines, resulting in side effects such as stomach-ache, diarrhea, fatigue, malnutrition and stunted growth in children. Continue reading

Hormone replacement therapy lowers risk of colorectal cancer

Research from the Carmel Medical Center in Haifa, Israel shows that hormone replacement therapy (HRT) reduces the risk of colorectal cancer in postmenopausal women. The study indicates a reduction of risk by more than half in women taking combined estrogen-progestin oral pills.

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Prediction of Metabolic Syndrome by Low Serum Testosterone Levels in Men

Abstract

OBJECTIVE The aim of this analysis was to assess the prospective association of serum testosterone and dehydroepiandrosterone sulfate (DHEAS) levels with incident metabolic syndrome (MetS) in men.

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Hormone Modulation

The Effect of a Program of Hormone Modulation, Low Glycemic, Nutrition and Exercise Instruction on Select Outcomes Indicative of Disease Risk and Subjective Impression of Quality of Life.

ALAN P. MINTZ, ANTON R. DOTSON, AND JHOANNA MUKAI

ABSTRACT

Substantial benefits of low glycemic nutrition, regular exercise and supplementation of recombinant human growth hormone (G), dehydroepiandrosterone (D), testosterone (T), estrogen (E) and progesterone (P) have been demonstrated independently of one another in controlled clinical trials in diseased and healthy men and women. We collected data retrospectively on 78 men and 29 women enrolled in a comprehensive program utilizing these interventions to see how parameters of disease risk and their subjective sense of quality of life would be altered. While self-directing their nutrition and exercise after detailed instruction, and achieving a substantial rise in levels of the above hormones appropriate for their sex, there were impressive improvements in lipid profiles, bone density, body composition, glucose metabolism, and quality of life outcomes. Side effects were mild and easily controlled.

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