Deficiência de GH em adultos: resultados do estudo multicêntrico brasileiro

Abstract

RESUMOAvaliamos 70 pacientes com deficiência de GH, 39 mulheres e 31 homens, com idades entre 18 e 69 anos (média de 38,3±13,5), provenientes de 3 centros no Brasil. A dose de reposição variou entre os centros, bem como a resposta do IGF-1, que mostrou maior aumento nos centros com maior dose de GH. Reposição de GH levou a um aumento significativo nos níveis de IGF-1 e HDL colesterol, bem como da densidade mineral óssea (DMO), e a uma redução significativa nos níveis de colesterol total e LDL colesterol, semelhante nos 3 centros. Encontramos aumento mais significativo de HDL colesterol nas mulheres e aumento mais acentuado da DMO nos pacientes do sexo masculino. Concluimos que reposição de GH leva à melhora do perfil lipídico e da DMO, e que doses menores apresentam o mesmo benefício, provavelmente com menor incidência de efeitos colaterais. ABSTRACT GH Deficiency in Adults: Results of the Brazilian Multicenter Study.We have evaluated 70 patients with GH deficiency, 39 females and 31 males, ranging in age from 18 to 69 years (mean: 38.3±13.5), from 3 centers in Brazil. GH replacement dose was different among the centers, as well as IGF-1 response to GH, which was more pronounced in patients using the highest GH dose. GH replacement led to a significant increase of IGF-1 and HDL cholesterol, as well as bone mineral density (BMD) and to a significant decrease in total and LDL cholesterol that was similar among the centers. Female patients showed a more significant increase of HDL cholesterol, while men showed a more significant increase of BMD. In conclusion, GH replacement led to an improvement of lipid profile and BMD. Lower GH dose may lead to the same benefits, probably with a lower incidence of side effects.

Additional Beneficial Effects of Recombinant Growth Hormone in Alendronate-treated Patients with Idiopathic Osteoporosis

“…Growth hormone has been used as a bone anabolic agent in GH-deficient patients [9,[20][21][22][23] and in some situations where the main factor causing osteoporosis was the decrease in osteoblastic function, such as anorexia nervosa [24], age [25] and idiopathic osteoporosis [26,27].…”

“…With the maintenance of rhGH replacement these markers decrease, but remain above baseline values [28], pointing to a continuing increased bone turno ver [9]. This may lead to an initial decline in BMD within the first year of rhGH treatment, although a net bone gain is well recognized with long term treatment [9,21,22,26].…”

Glucose Metabolism and Visceral Fat in GH Deficient Adults: Two Years of GH-Replacement

“…The results of a group of 70 patients from a Brazilian multicentric register, which is part of an international register, involving 10 different countries and around 1200 patients-Nordireg R , Novo Nordisk A/S-showed no alterations on glucose and insulin levels, as well as insulin resistance evaluated by HOM [42].…”

Correlation between basal serum IGF-1 levels and functional autonomy in elderly women. (Correlación entre los niveles sericos de IGF-1 basal y autonomía funcional en las ancianas).

“…ormone activity seems to be strongly influenced by the passage of time, especially among growth factors (IGF) (Conceição et al, 2003). The most important of these is the Insulin-Like Growth Factor-1 (IGF-1), which has a structure similar to that of insulin, and which may influence cell growth, differentiation and metabolism (Kjaer, 2004).…”