The Effects of 10 Years of Recombinant Human Growth Hormone (GH) in Adult GH-Deficient Patients

Abstract

The long term effects of GH replacement in adult GH-deficient (GHD) patients have not yet been clarified. We studied 21 GHD adults who originally took part in a randomized, double blind, placebo-controlled trial of GH treatment in 1987. After completion of that trial, 10 patients received continuous GH replacement for the subsequent 10 yr, whereas 11 did not. A group of 11 age- and sex-matched normal controls were also studied in 1987 and 1997. Lean body mass, as assessed by total body potassium measurement and computed tomography scanning of the dominant thigh, increased in the GH-treated group (P < 0.01 for both) only (P < 0.05 between groups for total body potassium). Low density lipoprotein cholesterol decreased in the GH-treated group (P < 0.05) only. Carotid intima media thickness was significantly greater (P < 0.05) in the untreated group than in the GH-treated group. Assessment of psychological well-being using the Nottingham Health Profile revealed improvement in overall score, energy levels, and emotional reaction in the GH-treated group compared with those in the untreated group (P < 0.02). In conclusion, GH treatment for 10 yr in GHD adults resulted in increased lean body and muscle mass, a less atherogenic lipid profile, reduced carotid intima media thickness, and improved psychological well-being.

Growth hormone induces age-dependent alteration in the expression of hippocampal growth hormone receptor and N -methyl- d -aspartate receptor subunits gene transcripts in male rats

“…As mentioned above, GH-replacement therapy in adult elderly GHD patients improves cognitive capability and memory function (7)(8)(9). In this study, focused on male rats, we did not observe any neurochemical evidence for a GH-induced enhancement of cognitive functions in elderly adult individuals.…”

“…However, as mentioned in the introductory statements, GH is shown to induce promoting effects on memory and learning processes, both in humans and rats. Thus, several studies (not all) suggest that GH replacement therapy improves cognitive performance (8,9). By use of animal models, GH was shown also to modulate memory function in the rat (10).…”

“…Untreated adult GHD patients exhibit general fatigue, lack of concentration, memory disabilities, and overall, a diminished subjective well being (4)(5)(6). Treatment of adult GHD patients with recombinant human GH is reported to induce increased psychological well being (1,2,5,7,8) and to improve cognitive efficiency and memory function (7)(8)(9). GH is also shown to affect learning processes and memory function in rats.…”

EXTENSIVE EXPERTISE IN ENDOCRINOLOGY: UK stance on adult GH replacement: the economist vs the endocrinologist

“…The data supporting these observations are gathered from patient interviews, and the use of generic and disease-generated questionnaires. The benefit in QoL is maintained for at least 6-10 years and the evidence is derived from audit of practice single centre studies (20,21) and pharmaceutical database registries (22).…”

Deficiência de GH em adultos: resultados do estudo multicêntrico brasileiro

“…Este estudo também demonstrou que, quanto maior o nível absoluto de IGF-1 ou quanto maior seu aumento com relação ao basal, maior a chance de piora da resistência insulínica nestes pacientes (40). Não obstante, em outros estudos não foi detectada deterioração da sensibilidade à insulina a longo prazo, utilizando o teste de tolerância oral à glicose ou o clamp hiperinsulinêmico (4,6,41). Os resultados discordantes dos diferentes estudos podem decorrer de diferenças de doses de GH empregadas (42), estado prévio de sensibilidade à insulina, idade, ou heterogeneidade dos grupos estudados.…”