Anabolic growth hormone action improves submaximal measures of physical performance in patients with HIV-associated wasting

Abstract

growth hormone action improves submaximal measures of physical performance in patients with HIV-associated wasting: a randomized, double-blind, placebo-controlled crossover trial. Am J Physiol Endocrinol Metab 289: E494 -E503, 2005. First published May 10, 2005 doi:10.1152/ajpendo.00013.2005.-Growth hormone (GH) treatment reverses the muscle loss allegedly responsible for diminished aerobic capacity and increased fatigue in patients with HIV-associated wasting. This study examined whether submaximal measures of physical performance can be used as objective measures of the functional impact of GH treatment-induced anabolism. We randomized 27 HIV-positive men [mean (SD) age, 43.9 (7.2) yr; body mass, 71.9 (10.4) kg; BMI, 23.1 (2.8) kg/m 2 ] with unintentional weight loss despite antiretroviral therapy to receive GH (6 mg) or placebo in a double-blinded, placebo-controlled, cross-over trial with a 3-mo washout. Lean body mass (LBM), maximum oxygen uptake (V O2 peak), ventilatory threshold (VeT), 6-min walk test (6MWT) distance and work, profile of mood states (POMS) fatigue and vigor scores, and Nottingham health profile (NHP) energy and physical mobility scores were measured. LBM significantly increased after 3 mo of GH treatment vs. placebo (means Ϯ SE, 3.7 Ϯ 0.6 vs. 0.3 Ϯ 0.4 kg; P Ͻ 0.001). VeT significantly improved (17.6 Ϯ 3.7 vs. Ϫ5.9 Ϯ 2.5%; P Ͻ 0.001), but V O2 peak did not change significantly. 6MWT distance improved (24.9 Ϯ 9.7 vs. 19.9 Ϯ 11.6 m; P Ͼ 0.05) and 6MWT work increased significantly more after 3 mo of GH treatment (33.3 Ϯ 8.8 vs. 16.5 Ϯ 7.5 kJ; P Ͻ 0.05). POMS scores of fatigue and vigor and the NHP score of energy improved, yet the changes were not statistically significant. GH treatment improved VeT linearly to the increase in LBM (r ϭ0.43, P ϭ 0.037) and 6MWT work (r ϭ 0.51, P ϭ 0.008), and the increase in 6MWT work correlated with increase in LBM (r ϭ 0.45, P ϭ 0.024). Improvement in 6MWT work above the median (27.3 kJ) showed a decrease in fatigue (r ϭ Ϫ0.62, P ϭ 0.024). We concluded that GH treatmentinduced LBM gains in HIV-associated wasting were functionally relevant, as determined by effort-independent submaximal measures of cardiopulmonary exercise testing.

Ambulatory Function in Men with and without HIV Infection: Association with Cardiorespiratory Fitness

“…Esposito and colleagues found the 6-MW distance to be 5% lower than expected in 27 younger men [11] using the same reference equation [12]. We reported a 8% lower 6-MW distance in 32 older HIV-infected men and a moderate correlation between the 6-MW distance and VO2peak [13].…”

Multidimensional health status of HIV-infected outpatients at a tertiary care center in north India

“…[50] Multiple treatment options are available for treatment of weight loss. [50][51][52][53] Tuberculosis is the most frequent opportunistic infection in HIV patients in India (54% of all AIDS patients). It is estimated that 2.6% to 8% of tuberculosis patients in India are HIV infected.…”

Six-Minute Walk Test for Persons with Mild or Moderate Disability from Multiple Sclerosis: Performance and Explanatory Factors

“…Originally developed to assess disability in patients with chronic obstructive lung disease, the 6-minute walk test (6MWT) has since been extensively studied and used with older persons and persons with heart failure, pulmonary hypertension, cardiovascular conditions, stroke, obesity, human immunodeficiency virus, acquired brain injury, adult cerebral palsy, and MS. [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Reference values for the 6MWT are reported for people aged 20 to 50 15 and 55 to 75 years. 16 Performance on the 6MWT is influenced by many factors, including age, 16,19,20,22 gender, 20 race, 20 height, 20 weight, 17,20 health condition (medications, 14 ), and psychological conditions (depression, cognition, affect).…”