Abstract
Objective: This study examines the effects of growth hormone replacement on body composition,
insulin sensitivity, lipid profile, endothelial dysfunction and carotid intima
media thickness in patients with adult-onset growth-hormone (GH) deficiency. Methods: Twelve patients with severe GH deficiency received GH replacement for one year.
In all patients, the following parameters were evaluated before and after six
and twelve months of therapy: fasting glucose, insulin levels and lipid profile,
bone mineral density and body composition. Carotid intima media thickness and
brachial flow-mediated dilatation were also evaluated by arterial ultrasonography
at basal condition and after one year of therapy. Results: No significant changes were seen in body weight and blood pressure, total fat
and lean mass, or bone mineral density after six months of GH replacement. There
was an increase in triglycerides (p = 0.05), while total and HDL cholesterol,
blood glucose, insulin levels did not change significantly. After twelve months,
an increase in lean mass and a decrease in fat mass (p < 0.01 vs. baseline), a decrease in insulin resistance (p < 0.01 vs. six months; p = 0.01 vs. baseline) and a decrease in triglycerides (p < 0.01) were observed. Intima
media thickness was greater in GH deficiency than in controls (p = 0.01) before
therapy, and was unchanged after twelve months of therapy, whereas the flow-mediated
dilatation tended to improve (p = 0.05). Conclusions: GH replacement is able to reverse typical metabolic and body composition
alterations in patients with adult GH deficiency after twelve months, but it is
unable to revert the vascular alteration completely. Flow-mediated dilatation
seems to be a more precocious marker of the remission of arterial damage.
Key words
Hypopituitarism - insulin sensitivity - lipid metabolism - body fat mass - endothelial
function
References
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