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Growth hormone treatment for HIV patients improves abdominal fat, but worsens glucose level
August 04, 2008For human immunodeficiency virus (HIV)-infected patients with treatment-related abdominal obesity and growth hormone deficiency, receiving low-dose growth hormone resulted in improvement in fat and blood pressure measurements but worsened glucose levels, according to a study in the August 6 issue of JAMA, a theme issue on HIV/AIDS.
Steven Grinspoon, M.D., of Massachusetts General Hospital, Boston, presented the findings of the study at a JAMA media briefing on HIV/AIDS.
Patients with HIV infection treated with antiretroviral therapy frequently develop changes in body composition, such as abdominal obesity, and metabolic complications of dyslipidemia (disorders of lipoprotein metabolism, including high cholesterol levels) and insulin resistance, putting these patients at increased cardiovascular risk. Growth hormone (GH) secretion is reduced in patients with HIV and abdominal fat accumulation, and relative GH deficiency (GHD) is observed in approximately one-third of such patients, according to background information in the article. Some studies have indicated that doses of growth hormone could decrease abdominal fat.
Dr. Grinspoon and colleagues conducted a study to determine whether low-dose GH in 56 HIV patients with abdominal fat accumulation and GH deficiency would improve body composition, lipids, and other metabolic and cardiovascular measures. Patients were randomly assigned to receive by injection either GH or matching placebo. Fifty-five patients (26 with GH and 29 with placebo) were included in the safety analyses and 52 patients (25 with GH and 27 with placebo) were included in the efficacy analyses.
The researchers found that abdominal fat decreased significantly in the GH group compared with the placebo group, with a percentage change in the GH group of −8.5 percent and −1.6 percent in the placebo group. Trunk-to-lower extremity fat ratio and trunk fat also decreased in the GH group compared with the placebo group.
Triglycerides and diastolic blood pressure (BP) levels improved with GH, while the change in systolic BP was not statistically different compared with placebo. Total cholesterol and high density lipoprotein (HDL) cholesterol levels were unchanged between the two groups. GH increased glucose levels during glucose tolerance testing, however long-term indices of glucose, hemoglobin A1c (the substance of red blood cells that carries oxygen to the cells and sometimes joins with glucose), were not different between the groups.
"Data from our randomized, placebo-controlled trial involving a long duration of observation inject a note of caution into the debate regarding the use of GH therapy in the HIV population," the authors write. "Low-dose physiological GH is well-tolerated and results in significant but more modest reduction in visceral adipose tissue [VAT; abdominal fat], but is nonetheless associated with increased glucose levels. Therefore, the therapeutic window to achieve an optimal risk-benefit ratio of GH in individuals with HIV, abdominal fat accumulation, and insulin resistance may be very narrow and difficult to achieve."
"Growth hormone is not yet FDA-approved for the treatment of abdominal fat accumulation in patients with HIV. Other more potent strategies to safely increase GH and reduce VAT, including the use of GH-releasing hormone (GHRH), may be more beneficial. In addition, strategies using diet, exercise, and lifestyle change may be more cost-effective in the long run than GH, particularly in patients with HIV, visceral adiposity, and insulin resistance, in whom changes in glucose may be counterproductive," the researchers conclude.
JAMA and Archives Journals
Dr. Grinspoon and colleagues conducted a study to determine whether low-dose GH in 56 HIV patients with abdominal fat accumulation and GH deficiency would improve body composition, lipids, and other metabolic and cardiovascular measures. Patients were randomly assigned to receive by injection either GH or matching placebo. Fifty-five patients (26 with GH and 29 with placebo) were included in the safety analyses and 52 patients (25 with GH and 27 with placebo) were included in the efficacy analyses.
The researchers found that abdominal fat decreased significantly in the GH group compared with the placebo group, with a percentage change in the GH group of −8.5 percent and −1.6 percent in the placebo group. Trunk-to-lower extremity fat ratio and trunk fat also decreased in the GH group compared with the placebo group.
Triglycerides and diastolic blood pressure (BP) levels improved with GH, while the change in systolic BP was not statistically different compared with placebo. Total cholesterol and high density lipoprotein (HDL) cholesterol levels were unchanged between the two groups. GH increased glucose levels during glucose tolerance testing, however long-term indices of glucose, hemoglobin A1c (the substance of red blood cells that carries oxygen to the cells and sometimes joins with glucose), were not different between the groups.
"Data from our randomized, placebo-controlled trial involving a long duration of observation inject a note of caution into the debate regarding the use of GH therapy in the HIV population," the authors write. "Low-dose physiological GH is well-tolerated and results in significant but more modest reduction in visceral adipose tissue [VAT; abdominal fat], but is nonetheless associated with increased glucose levels. Therefore, the therapeutic window to achieve an optimal risk-benefit ratio of GH in individuals with HIV, abdominal fat accumulation, and insulin resistance may be very narrow and difficult to achieve."
"Growth hormone is not yet FDA-approved for the treatment of abdominal fat accumulation in patients with HIV. Other more potent strategies to safely increase GH and reduce VAT, including the use of GH-releasing hormone (GHRH), may be more beneficial. In addition, strategies using diet, exercise, and lifestyle change may be more cost-effective in the long run than GH, particularly in patients with HIV, visceral adiposity, and insulin resistance, in whom changes in glucose may be counterproductive," the researchers conclude.
JAMA and Archives Journals
Growth Hormone Current Events and Growth Hormone News RSSHormone therapy helps short children grow up
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An Anti-Frailty Pill for Seniors?
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Calorie restriction, a diet that is low in calories and high in nutrition, may not be as effective at extending life in people as it is in rodents, according to scientists at Washington University School of Medicine in St. Louis.
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Growth hormone reduces abdominal fat, cardiovascular risk in HIV patients on antiviral therapy
Low-dose growth hormone treatment reduced abdominal fat deposits and improved blood pressure and triglyceride levels in a group of patients with HIV lipodystrophy, a condition involving the redistribution of fat and other metabolic changes in patients receiving combination drug therapy for HIV infection.
Growth hormone's link to starvation may be clue to increasing life span, researchers find
Researchers at UT Southwestern Medical Center have determined that starvation blocks the effects of growth hormone via a mechanism that may have implications in treating diabetes and extending life span.
Scientists find potential protein biomarkers for growth hormone
Ohio University scientists have identified several proteins in mice that might act as biomarkers for growth hormone. The research could be the first step to finding a more reliable way to detect recombinant human growth hormone (rhGH), which some athletes and teenagers use illegally to boost muscle and reduce fat.
Growth hormone is used to treat twice as many short boys than girls in the US and Asia
Boys are twice as likely as girls in the U.S. and Asia (mostly Japan) to receive recombinant human growth hormone (rhGH) for growth hormone deficiency, illnesses that affect height, and short stature of a non-medical nature.
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