Three years of growth hormone treatment in growth hormone-deficient adults: near normalization of body composition and physical performance

Medical Department M (Diabetes and Endocrinology), Aarhus Kommunehospital, Denmark.

Growth hormone (GH) replacement therapy in several controlled short-term trials have shown unanimous beneficial effects on body composition and other features. To evaluate more long-term effects we report data from 3 years of uninterrupted GH therapy in 10 GH-deficient adults who had all completed a previous double-blind placebo-controlled study and who also had been studied after 16 months of open GH therapy. No further increase in linear height was observed. The initial increase in thigh muscle volume was maintained after 3 years of GH therapy. A slight increase in body weight and thigh fat volume was recorded. Exercise capacity and isometric muscle strength were increased significantly compared to the initial placebo period. This was associated with stabilized levels of resting heart rate and blood pressure. Glycosylated hemoglobin levels were normal and did not change during the study. A standard oral glucose tolerance test performed at the end of the study revealed no evidence of glucose intolerance. No side-effects were reported. Compared to an age- and sex-matched group of healthy untreated subjects, thigh muscle volume, exercise capacity and isometric muscle strength had become normalized from subnormal levels after 3 years of GH therapy. We conclude that long-term GH replacement therapy in GH-deficient adults is associated with preserved beneficial effects on body composition and physical performance, resulting in a near normalization of several previously abnormal features and adding new merits to this treatment modality.

This article has been cited by other articles:

				H. Liu, D. M. Bravata, I. Olkin, S. Nayak, B. Roberts, A. M. Garber, and A. R. Hoffman Systematic Review: The Safety and Efficacy of Growth Hormone in the Healthy Elderly Ann Intern Med, January 16, 2007; 146(2): 104 - 115. [Abstract] [Full Text] [PDF]

				L. J. Woodhouse, A. Mukherjee, S. M. Shalet, and S. Ezzat The Influence of Growth Hormone Status on Physical Impairments, Functional Limitations, and Health-Related Quality of Life in Adults Endocr. Rev., May 1, 2006; 27(3): 287 - 317. [Abstract] [Full Text] [PDF]

				M. E. Molitch, D. R. Clemmons, S. Malozowski, G. R. Merriam, S. M. Shalet, M. L. Vance, and for The Endocrine Society's Clinical Guidelines Su Evaluation and Treatment of Adult Growth Hormone Deficiency: An Endocrine Society Clinical Practice Guideline J. Clin. Endocrinol. Metab., May 1, 2006; 91(5): 1621 - 1634. [Abstract] [Full Text] [PDF]

				S. Marleau, M. Mulumba, D. Lamontagne, and H. Ong Cardiac and peripheral actions of growth hormone and its releasing peptides: Relevance for the treatment of cardiomyopathies Cardiovasc Res, January 1, 2006; 69(1): 26 - 35. [Abstract] [Full Text] [PDF]

				J. Bollerslev, J. Hallen, K. J Fougner, A. P. Jorgensen, C. Kristo, H. Fagertun, O. Gudmundsen, P. Burman, and T. Schreiner Low-dose GH improves exercise capacity in adults with GH deficiency: effects of a 22-month placebo-controlled, crossover trial Eur. J. Endocrinol., September 1, 2005; 153(3): 379 - 387. [Abstract] [Full Text] [PDF]

				K. Chihara, E. Koledova, A. Shimatsu, Y. Kato, H. Kohno, T. Tanaka, A. Teramoto, P. C Bates, and A. F Attanasio An individualized GH dose regimen for long-term GH treatment in Japanese patients with adult GH deficiency Eur. J. Endocrinol., July 1, 2005; 153(1): 57 - 65. [Abstract] [Full Text] [PDF]

				J. D. Veldhuis, J. N. Roemmich, E. J. Richmond, A. D. Rogol, J. C. Lovejoy, M. Sheffield-Moore, N. Mauras, and C. Y. Bowers Endocrine Control of Body Composition in Infancy, Childhood, and Puberty Endocr. Rev., February 1, 2005; 26(1): 114 - 146. [Abstract] [Full Text] [PDF]

				A. R. Hoffman, C. J. Strasburger, A. Zagar, W. F. Blum, A. Kehely, and M. L. Hartman Efficacy and Tolerability of an Individualized Dosing Regimen for Adult Growth Hormone Replacement Therapy in Comparison with Fixed Body Weight-Based Dosing J. Clin. Endocrinol. Metab., July 1, 2004; 89(7): 3224 - 3233. [Abstract] [Full Text] [PDF]

				S. M. Harman and M. R. Blackman Hormones and Supplements: Do They Work?: Use of Growth Hormone for Prevention or Treatment of Effects of Aging J. Gerontol. A Biol. Sci. Med. Sci., July 1, 2004; 59(7): B652 - B658. [Abstract] [Full Text] [PDF]

				A. R. Hoffman, J. E. Kuntze, J. Baptista, H. B. A. Baum, G. P. Baumann, B. M. K. Biller, R. V. Clark, D. Cook, S. E. Inzucchi, D. Kleinberg, et al. 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 J. Clin. Endocrinol. Metab., May 1, 2004; 89(5): 2048 - 2056. [Abstract] [Full Text] [PDF]

				M. Hayakawa, Y. Shimazaki, T. Tsushima, Y. Kato, K. Takano, K. Chihara, A. Shimatsu, and M. Irie Metabolic Effects of 20-Kilodalton Human Growth Hormone (20K-hGH) for Adults with Growth Hormone Deficiency: Results of an Exploratory Uncontrolled Multicenter Clinical Trial of 20K-hGH J. Clin. Endocrinol. Metab., April 1, 2004; 89(4): 1562 - 1571. [Abstract] [Full Text] [PDF]

				L. E. Underwood, K. M. Attie, and J. Baptista Growth Hormone (GH) Dose-Response in Young Adults with Childhood-Onset GH Deficiency: A Two-Year, Multicenter, Multiple-Dose, Placebo-Controlled Study J. Clin. Endocrinol. Metab., November 1, 2003; 88(11): 5273 - 5280. [Abstract] [Full Text] [PDF]

				A. Kehely, P. C. Bates, P. Frewer, M. Birkett, W. F. Blum, P. Mamessier, S. Ezzat, K. K. Y. Ho, G. Lombardi, A. Luger, et al. Short-Term Safety and Efficacy of Human GH Replacement Therapy in 595 Adults with GH Deficiency: A Comparison of Two Dosage Algorithms J. Clin. Endocrinol. Metab., May 1, 2002; 87(5): 1974 - 1979. [Abstract] [Full Text] [PDF]

				T. Laursen, C. H. Gravholt, L. Heickendorff, J. Drustrup, A.-M. Kappelgaard, J. O. L. Jørgensen, and J. S. Christiansen Long-Term Effects of Continuous Subcutaneous Infusion Versus Daily Subcutaneous Injections of Growth Hormone (GH) on the Insulin-Like Growth Factor System, Insulin Sensitivity, Body Composition, and Bone and Lipoprotein Metabolism in GH-Deficient Adults J. Clin. Endocrinol. Metab., March 1, 2001; 86(3): 1222 - 1228. [Abstract] [Full Text]

				B. M. K. Biller, G. Sesmilo, H. B. A. Baum, D. Hayden, D. Schoenfeld, and A. Klibanski Withdrawal of Long-Term Physiological Growth Hormone (GH) Administration: Differential Effects on Bone Density and Body Composition in Men with Adult-Onset GH Deficiency J. Clin. Endocrinol. Metab., March 1, 2000; 85(3): 970 - 976. [Abstract] [Full Text]

				Degree of Fatness after Treatment for Acute Lymphoblastic Leukemia in Childhood J. Clin. Endocrinol. Metab., December 1, 1999; 84(12): 4591 - 4596. [Abstract] [Full Text]

				M. L. Vance and N. Mauras Growth Hormone Therapy in Adults and Children N. Engl. J. Med., October 14, 1999; 341(16): 1206 - 1216. [Full Text] [PDF]

				R. Bross, M. Javanbakht, and S. Bhasin Anabolic Interventions for Aging-Associated Sarcopenia J. Clin. Endocrinol. Metab., October 1, 1999; 84(10): 3420 - 3430. [Full Text] [PDF]

				J. Gibney, J. D. Wallace, T. Spinks, L. Schnorr, A. Ranicar, R. C. Cuneo, S. Lockhart, K. G. Burnand, F. Salomon, P. H. Sonksen, et al. The Effects of 10 Years of Recombinant Human Growth Hormone (GH) in Adult GH-Deficient Patients J. Clin. Endocrinol. Metab., August 1, 1999; 84(8): 2596 - 2602. [Abstract] [Full Text]

				D. M. Hoffman, R. Pallasser, M. Duncan, T. V. Nguyen, and K. K. Y. Ho How Is Whole Body Protein Turnover Perturbed in Growth Hormone-Deficient Adults? J. Clin. Endocrinol. Metab., December 1, 1998; 83(12): 4344 - 4349. [Abstract] [Full Text]

				J. Leger, C. Garel, A. Fjellestad-Paulsen, M. Hassan, and P. Czernichow Human Growth Hormone Treatment of Short-Stature Children Born Small for Gestational Age: Effect on Muscle and Adipose Tissue Mass during a 3-Year Treatment Period and after 1 Year's Withdrawal J. Clin. Endocrinol. Metab., October 1, 1998; 83(10): 3512 - 3516. [Abstract] [Full Text]

				D. L. Russell-Jones, S. B. Bowes, S. E. Rees, N. C. Jackson, A. J. Weissberger, R. Hovorka, P. H. Sonksen, and A. M. Umpleby Effect of growth hormone treatment on postprandial protein metabolism in growth hormone-deficient adults Am J Physiol Endocrinol Metab, June 1, 1998; 274(6): E1050 - E1056. [Abstract] [Full Text] [PDF]

				P. V. Carroll, E. R. Christ the members of Growth Hormone Research Soci, B. A. Bengtsson, L. Carlsson, J. S. Christiansen, D. Clemmons, R. Hintz, K. Ho, Z. Laron, P. Sizonenko, et al. Growth Hormone Deficiency in Adulthood and the Effects of Growth Hormone Replacement: A Review J. Clin. Endocrinol. Metab., February 1, 1998; 83(2): 382 - 395. [Abstract] [Full Text]

				R. Bottinelli, M. Narici, M. A. Pellegrino, B. Kayser, M. Canepari, G. Faglia, and A. Sartorio Contractile Properties and Fiber Type Distribution of Quadriceps Muscles in Adults with Childhood-Onset Growth Hormone Deficiency J. Clin. Endocrinol. Metab., December 1, 1997; 82(12): 4133 - 4138. [Abstract] [Full Text] [PDF]

				M. Tauber, P. Moulin, C. Pienkowski, B. Jouret, and P. Rochiccioli Growth Hormone (GH) Retesting and Auxological Data in 131 GH-Deficient Patients after Completion of Treatment J. Clin. Endocrinol. Metab., February 1, 1997; 82(2): 352 - 356. [Abstract] [Full Text] [PDF]