HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (3) Citing Articles via Google Scholar Google Scholar Articles by Engström, B. E. Articles by Karlsson, F A. Search for Related Content PubMed PubMed Citation Articles by Engström, B. E. Articles by Karlsson, F A.

Effects of gastric bypass on the GH/IGF-I axis in severe obesity – and a comparison with GH deficiency

Department of Medical Sciences, Internal Medicine, ¹ Department of Public Health and Caring Sciences and ² Department of Geriatrics and Surgery, Uppsala University Hospital, S-75185 Uppsala, Sweden

(Correspondence should be addressed to B Edén Engström; Email: britt.eden_engstrom{at}medsci.uu.se)

Objective: Overfeeding suppresses GH secretion and makes evaluation of a suspected GH deficiency (GHD) difficult. In normal weight subjects, gender is known to influence GH concentrations, which is most apparent in the ambulatory, morning-fasted state. In this study, we examined the GH/IGF-I axis in obese men and women and the effect of surgically induced weight loss.

Design: Sixty-three subjects (body mass index (BMI) 45 ± 6 kg/m²; 54 women, 9 men) were studied prior to, and 6 and 12 months following Roux-en-Y gastric bypass (RYGBP) surgery. Fifty-four patients with classic GHD (BMI 27 ± 6 kg/m²; 35 men, 19 women) were included for comparison. Methods: Hormones were analysed in fasting morning serum samples.

Results: RYGBP resulted in a decreased BMI to 35 ± kg/m² at 6 months and 32 ± 6 kg/m² at 12 months. GH and IGF-I increased at 6 months in the women and at 12 months in both sexes by 300 and 11% respectively. Prior to RYGBP, GH concentrations were low in the obese men and similar to those of GHD men (mean 0.09 mU/l). Obese women had tenfold higher values than obese men and sevenfold higher than GHD women. IGF-I levels were in the low reference range in the obese and below –2 S.D. for age in 13%.

Conclusions: Surgically induced weight loss partially restores GH secretion. Despite a marked suppression of GH values, a gender influence is maintained in severe obesity. In obese women, single morning GH and IGF-I values seem sufficient to exclude a suspicion of classic GHD.

This article has been cited by other articles:

				S. Savastano, C. Di Somma, L. Angrisani, F. Orio, S. Longobardi, G. Lombardi, and A. Colao Growth Hormone Treatment Prevents Loss of Lean Mass after Bariatric Surgery in Morbidly Obese Patients: Results of a Pilot, Open, Prospective, Randomized, Controlled Study J. Clin. Endocrinol. Metab., March 1, 2009; 94(3): 817 - 826. [Abstract] [Full Text] [PDF]

				A. L. Utz, A. Yamamoto, P. Sluss, J. Breu, and K. K. Miller Androgens May Mediate a Relative Preservation of IGF-I Levels in Overweight and Obese Women Despite Reduced Growth Hormone Secretion J. Clin. Endocrinol. Metab., October 1, 2008; 93(10): 4033 - 4040. [Abstract] [Full Text] [PDF]

				J. Terrien, P. Zizzari, M.-T. Bluet-Pajot, P.-Y. Henry, M. Perret, J. Epelbaum, and F. Aujard Effects of age on thermoregulatory responses during cold exposure in a nonhuman primate, Microcebus murinus Am J Physiol Regulatory Integrative Comp Physiol, August 1, 2008; 295(2): R696 - R703. [Abstract] [Full Text] [PDF]

				M. H. Rasmussen, A. Juul, L. L. Kjems, and J. Hilsted Effects of short-term caloric restriction on circulating free IGF-I, acid-labile subunit, IGF-binding proteins (IGFBPs)-1-4, and IGFBPs-1-3 protease activity in obese subjects. Eur. J. Endocrinol., October 1, 2006; 155(4): 575 - 581. [Abstract] [Full Text] [PDF]