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Metabolic profile in growth hormone-deficient (GHD) adults after long-term recombinant human growth hormone (rhGH) therapy.
J Clin Endocrinol Metab. 2013 Jan; 98(1):352-61.JC

Abstract

BACKGROUND

The metabolic effects of recombinant human GH (rhGH) therapy in adults are well-documented in the short term. The effects of long-term rhGH therapy beyond 5 yr on metabolic parameters are presently unknown.

OBJECTIVE

The aim of the study was to evaluate the long-term effects of rhGH treatment on biochemical and anthropometric parameters in a large cohort of GH-deficient adults.

METHODS

Ninety-eight GH-deficient adult patients treated with rhGH for at least 10 yr were included (mean age, 59.4 yr; 50% female). Total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, anthropometric parameters, IGF-I, and glucose were evaluated at baseline and after 5, 10, and 15 yr of treatment. In addition, the prevalence of the metabolic syndrome (MS) and the incidence of cardiovascular events were assessed.

RESULTS

Total cholesterol and low-density lipoprotein cholesterol concentrations were lower, and high-density lipoprotein cholesterol levels were significantly higher during long-term rhGH replacement when compared to baseline (all P < 0.001). Both waist circumference (P < 0.001) and body mass index (P = 0.018) were significantly higher after 10 yr, as were fasting plasma glucose levels (P < 0.001). No significant changes were observed in triglycerides, waist-to-hip ratio, and blood pressure during follow-up. In the subset of patients with 15-yr rhGH treatment (n = 43), generally similar metabolic effects were found. MS prevalence was increased after 10 yr of rhGH treatment (57.1 vs. 32.7%; P < 0.001), especially in males (69.4 vs. 32.7%; P < 0.001).

CONCLUSION

Despite improvement of several cardiovascular risk factors, MS prevalence increased significantly during rhGH treatment. The effect of long-term rhGH treatment on overall cardiovascular risk profile needs to be established in a larger cohort.

Authors+Show Affiliations

Department of Endocrinology and Metabolic Diseases C4-R, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands. K.M.J.A.Claessen@lumc.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

23162104

Citation

Claessen, Kim M J A., et al. "Metabolic Profile in Growth Hormone-deficient (GHD) Adults After Long-term Recombinant Human Growth Hormone (rhGH) Therapy." The Journal of Clinical Endocrinology and Metabolism, vol. 98, no. 1, 2013, pp. 352-61.
Claessen KM, Appelman-Dijkstra NM, Adoptie DM, et al. Metabolic profile in growth hormone-deficient (GHD) adults after long-term recombinant human growth hormone (rhGH) therapy. J Clin Endocrinol Metab. 2013;98(1):352-61.
Claessen, K. M., Appelman-Dijkstra, N. M., Adoptie, D. M., Roelfsema, F., Smit, J. W., Biermasz, N. R., & Pereira, A. M. (2013). Metabolic profile in growth hormone-deficient (GHD) adults after long-term recombinant human growth hormone (rhGH) therapy. The Journal of Clinical Endocrinology and Metabolism, 98(1), 352-61. https://doi.org/10.1210/jc.2012-2940
Claessen KM, et al. Metabolic Profile in Growth Hormone-deficient (GHD) Adults After Long-term Recombinant Human Growth Hormone (rhGH) Therapy. J Clin Endocrinol Metab. 2013;98(1):352-61. PubMed PMID: 23162104.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metabolic profile in growth hormone-deficient (GHD) adults after long-term recombinant human growth hormone (rhGH) therapy. AU - Claessen,Kim M J A, AU - Appelman-Dijkstra,Natasha M, AU - Adoptie,Desirée M M M, AU - Roelfsema,Ferdinand, AU - Smit,Johannes W A, AU - Biermasz,Nienke R, AU - Pereira,Alberto M, Y1 - 2012/11/15/ PY - 2012/11/20/entrez PY - 2012/11/20/pubmed PY - 2013/3/8/medline SP - 352 EP - 61 JF - The Journal of clinical endocrinology and metabolism JO - J. Clin. Endocrinol. Metab. VL - 98 IS - 1 N2 - BACKGROUND: The metabolic effects of recombinant human GH (rhGH) therapy in adults are well-documented in the short term. The effects of long-term rhGH therapy beyond 5 yr on metabolic parameters are presently unknown. OBJECTIVE: The aim of the study was to evaluate the long-term effects of rhGH treatment on biochemical and anthropometric parameters in a large cohort of GH-deficient adults. METHODS: Ninety-eight GH-deficient adult patients treated with rhGH for at least 10 yr were included (mean age, 59.4 yr; 50% female). Total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, anthropometric parameters, IGF-I, and glucose were evaluated at baseline and after 5, 10, and 15 yr of treatment. In addition, the prevalence of the metabolic syndrome (MS) and the incidence of cardiovascular events were assessed. RESULTS: Total cholesterol and low-density lipoprotein cholesterol concentrations were lower, and high-density lipoprotein cholesterol levels were significantly higher during long-term rhGH replacement when compared to baseline (all P < 0.001). Both waist circumference (P < 0.001) and body mass index (P = 0.018) were significantly higher after 10 yr, as were fasting plasma glucose levels (P < 0.001). No significant changes were observed in triglycerides, waist-to-hip ratio, and blood pressure during follow-up. In the subset of patients with 15-yr rhGH treatment (n = 43), generally similar metabolic effects were found. MS prevalence was increased after 10 yr of rhGH treatment (57.1 vs. 32.7%; P < 0.001), especially in males (69.4 vs. 32.7%; P < 0.001). CONCLUSION: Despite improvement of several cardiovascular risk factors, MS prevalence increased significantly during rhGH treatment. The effect of long-term rhGH treatment on overall cardiovascular risk profile needs to be established in a larger cohort. SN - 1945-7197 UR - https://www.unboundmedicine.com/medline/citation/23162104/Metabolic_profile_in_growth_hormone_deficient__GHD__adults_after_long_term_recombinant_human_growth_hormone__rhGH__therapy_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2012-2940 DB - PRIME DP - Unbound Medicine ER -