Recombinant human growth hormone improves the fat redistribution syndrome (lipodystrophy) in patients with HIV

Wanke, Christine; Gerrior, Jül; Kantaros, Julie; Coakley, Eoin; Albrecht, Mary

doi:10.1097/00002030-199910220-00013

Cited by 118 publications

(57 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…rhGH treatment-mediated improvements in exercise physiological and functional performance have been documented in patients with adult growth hormone deficiency (41,49,65). It is well known that in patients with HIV, rhGH treatment increases LBM, reduces total body fat (TBF) (34,39,50), and ameliorates lipodystrophy (27,62). The impact of rhGH administration on physical performance has been measured using cycle (39) and treadmill ergometry (50).…”

mentioning

confidence: 99%

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

Esposito¹,

Thomas²,

Kingdon³

et al. 2005

American Journal of Physiology-Endocrinology and Metabolism

View full text Add to dashboard Cite

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.

show abstract

mentioning

confidence: 99%

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

Esposito¹,

Thomas²,

Kingdon³

et al. 2005

American Journal of Physiology-Endocrinology and Metabolism

View full text Add to dashboard Cite

show abstract

“…It is believed that fat redistribution affects long-term health outcomes by exacerbating the associated metabolic alterations (9, 12), which is a rationale for its treatment. Studies have shown that growth hormone secretion is suppressed in HIV-positive or HIV-negative subjects with increased IAAT (24, 25), and therapy with recombinant human growth hormone (rhGH) reduces IAAT contents (6,16,28). However, the effect of rhGH on relative changes of IAAT subcompartments has not been investigated.…”

mentioning

confidence: 99%

Preferential loss of omental-mesenteric fat during growth hormone therapy of HIV-associated lipodystrophy

Engelson

Albu³

et al. 2003

Journal of Applied Physiology

View full text Add to dashboard Cite

. Preferential loss of omental-mesenteric fat during growth hormone therapy of HIV-associated lipodystrophy. J Appl Physiol 94: 2051-2057, 2003; 10.1152/japplphysiol.00845.2002.-Lipodystrophy with increased intra-abdominal fat in human immunodeficiency virus (HIV) infection is common in the era of highly active antiretroviral therapy. It contributes to the metabolic derangements, as it does in non-HIVrelated conditions. Growth hormone administration reduces intra-abdominal fat content. This study compared the relative changes in omental-mesenteric (OMAT) and retroperitoneal adipose tissues (RPAT) during therapy with recombinant human growth hormone (rhGH) in HIVassociated lipodystrophy. Of 30 subjects who began rhGH therapy (6 mg/day), 25 completed 12 wk and 19 completed 24 wk. Fourteen subjects were followed for an additional 12 wk. Volumes of OMAT and RPAT were calculated from total body MRI scans and compared by paired t-tests. Both OMAT and RPAT significantly decreased after 12 and 24 wk of rhGH treatment (P Ͻ 0.001), but the reduction was more pronounced in OMAT than in RPAT (P Ͻ 0.001). Both OMAT and RPAT increased significantly (P Ͻ 0.001) after therapy was discontinued, but OMAT increased significantly more than did RPAT (122 vs. 37%, P Ͻ 0.001). There is preferential loss and regain of OMAT, compared with RPAT, in subjects with HIV-associated lipodystrophy undergoing growth hormone treatment.intra-abdominal adipose tissue; retroperitoneal adipose tissue; visceral adipose tissue; fat redistribution; body composition; human immunodeficiency virus INCREASED INTRA-ABDOMINAL ADIPOSE TISSUE (IAAT) has been linked to metabolic perturbations, especially hyperlipidemia and insulin resistance (21, 23), and reduction of intra-abdominal fat has been shown to improve insulin sensitivity in both animals (2) and humans (17,26). A substantial proportion of human immunodeficiency virus (HIV)-infected individuals on highly active antiretroviral therapy (HAART) develop fat redistribution, or HIV lipodystrophy, which is characterized by increased IAAT and/or depletion of subcutaneous adipose tissue (3-5). It is believed that fat redistribution affects long-term health outcomes by exacerbating the associated metabolic alterations (9, 12), which is a rationale for its treatment. Studies have shown that growth hormone secretion is suppressed in HIV-positive or HIV-negative subjects with increased IAAT (24, 25), and therapy with recombinant human growth hormone (rhGH) reduces IAAT contents (6,16,28). However, the effect of rhGH on relative changes of IAAT subcompartments has not been investigated.The IAAT compartment is complex and includes the retroperitoneal adipose tissue (RPAT) compartment, which is located posterior to the parietal peritoneal membrane, and the omental and mesenteric adipose tissue (OMAT) compartment, which includes the omentum, the serosal layer of the luminal gastrointestinal tract, and the mesentery. The anatomic differences between OMAT and RPAT are quite straightforward. In addition to their different...

show abstract

“…Torres and colleagues noted an effect of growth hormone on patients with buffalo hump using a dose of 6mg per day [19] . Wanke and colleagues [20] , Nguyen and colleagues [21] and Mauss and colleagues [22] also demonstrated decreases in trunk fat and visceral fat in response to rhGH doses of 6 mg per day. Lo and colleagues [23] evaluated the effects of 3 mg per day, both on body composition and insulin resistance and corroborated Johannsen's finding [16] that insulin resistance rose early in the course of treatment, then returned to baseline with prolonged therapy.…”

Section: Studies Of Growth Hormone In Hiv-associated Lipodystrophymentioning

confidence: 99%

The Effects of Growth Hormone Therapy in HIV-infection

Kotler¹

2006

American J. of Infectious Diseases

View full text Add to dashboard Cite

show abstract

Recombinant human growth hormone improves the fat redistribution syndrome (lipodystrophy) in patients with HIV

Abstract: Short-term treatment with rhGH improved the alterations in body shape that occur with FRS in HIV-infected patients. Waist/hip ratios and mid-thigh circumference are useful measures to follow alterations in body shape in FRS.

Cited by 118 publications

References 16 publications

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

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

Preferential loss of omental-mesenteric fat during growth hormone therapy of HIV-associated lipodystrophy

The Effects of Growth Hormone Therapy in HIV-infection

Contact Info

Product

Resources

About