GH response to GHRH-arginine testing is reduced in both overweight and obese subjects and negatively associated with indices of central abdominal obesity including WC, trunk fat, and visceral adipose tissue. The use of waist circumference, as a surrogate for central adiposity, adds predictive information to the determination of GH response, independent of BMI.

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HIV-infected men with fat redistribution have significantly reduced GH peak responses and increased failure rates to standardized GH stimulation testing in comparison to healthy male control subjects and to HIV-infected women of similar age and body mass index. GH secretion is related to gender and race in HIV-infected patients.

SUMMARYObjective: Relative growth hormone (GH) deficiency is highly prevalent in patients with HIV. The purpose of this study was to investigate relationships of GH to metabolic and anthropometric parameters in HIV patients and non-HIV controls.Design: Peak GH and metabolic parameters were assessed in a cross-sectional study of 191 HIV patients and 62 age and BMI-matched healthy controls.Methods: Peak GH was assessed by GHRH/arginine stimulation testing. Results:HIV patients demonstrated similar BMI, but increased waist circumference (WC) and reduced peak GH to GHRH/arginine compared with control subjects (12.4 [6.3, 24.8] vs. 21.3 [8.8, 34.5] μg/l, P=0.006, HIV vs. control). Among HIV and non-HIV groups, peak GH was inversely associated with WC (rho=−0.44, p<0.0001; rho=−0.63, p<0.0001)(HIV patients and controls, respectively), blood pressure (rho=−0.17, p=0.02; rho=−0.36, p=0.004), triglycerides (rho=−0.37, p<0.0001; rho=−0.43, p=0.001), glucose (rho=−0.34, p<0.0001; rho=−0.30, p=0.02), insulin (rho=−0.43, p<0.0001; rho=−0.60, p<0.0001) and CRP (rho=−0.29, p<0.0001; rho=−0.59, p<0.0001). Among HIV patients, the inverse association between peak GH and fasting glucose remained significant (β=−0.006mmol/l change in glucose per μg/l change in GH, p=0.004) controlling for age, gender, race, BMI, WC, protease inhibitor(PI) and nucleoside reverse transcriptase inhibitors(NRTI). Similarly, the inverse association between peak GH and triglycerides remained significant (β=−0.01mmol/l change in triglycerides per μg/l change in GH, p=0.02) controlling for age, gender, race, BMI, WC, PI and lipid-lowering medications. HIV men with peak GH<7.5μg/l demonstrated higher BMI, WC, SBP, triglycerides, glucose and CRP. Conclusions:Reduced GH secretion is independently associated with dyslipidemia and higher glucose, among HIV patients with abdominal fat accumulation.