The Effects of Treatment with Recombinant Human Growth Hormone on Body Composition and Metabolism in Adults with Growth Hormone Deficiency

Salomon, Franco; Cuneo, Ross C.; Hesp, R.; Sönksen, Peter H.

doi:10.1056/nejm198912283212605

Cited by 1,292 publications

(870 citation statements)

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“…20,32 Besides, it was suggested that estrogen may attenuate growth hormone (GH) signaling 33 and GH was reported to increase lipid oxidation 34 and reduce body fatness. 35 In sum, estrogen can affect obesity phenotypes through different pathways which may interact with each other, and much work is needed to understand its precise role in obesity.…”

Section: Discussionmentioning

confidence: 99%

Genetic and environmental correlations between obesity phenotypes and age at menarche

Wang

Zhao

et al. 2006

Int J Obes

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Objective: To assess the extent that the genetic and environmental factors contribute to the phenotypic correlations between obesity traits and age at menarche (AAM), and also to examine the influence of AAM on obesity in both pre-and postmenopausal women. Methods: Five hundred and twelve pedigrees with 2667 Caucasian female subjects from two to four generations were recruited. Fat mass and lean mass (both in kg) were measured by dual-energy X-ray absorptiometry scanner. Body mass index (BMI) (kg/m 2 ) was calculated. We performed bivariate quantitative genetic analyses in the total sample containing 2667 Caucasian women. We also selected 206 unrelated premenopausal women and 140 unrelated postmenopausal women from the total sample, and computed the respective phenotypic correlation between obesity and AAM in these two subgroups. Results: For fat mass, lean mass and BMI, we detected their significant negative genetic correlations with AAM after adjustment for significant covariates, which were À0.3170 (Po0.001), À0.1721 (Po0.05) and À0.3665 (Po0.001), respectively. However, their environmental correlations with AAM were all nonsignificant (P40.05), ranging from À0.0016 to 0.0192. In the premenopausal subgroup, significant associations were observed between fat mass and AAM (r ¼ À0.231, Po0.01) as well as between BMI and AAM (r ¼ À0.257, Po0.01). In the postmenopausal subgroup, no such associations were observed. Conclusion: Our results for the first time suggested that significant phenotypic association between obesity phenotypes and AAM is mainly attributable to shared genetic rather than environmental factors, and AAM may have stronger effects on obesity phenotypes in pre-than in postmenopausal women.

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Section: Discussionmentioning

confidence: 99%

Genetic and environmental correlations between obesity phenotypes and age at menarche

Wang

Zhao

et al. 2006

Int J Obes

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“…This can also occur after irradiation or surgery of this region 6,10 ' 12 ' 17 ' 21 " 23 . Although there is no consensus of which would be the best method to detect GHd in adults 6,7,12 * 21 , Hoffman et al 12 have demonstrated that the ITT is extremely accurate in differentiating subjects with organic GHd from normal matched subjects.…”

Section: Discussionmentioning

confidence: 99%

Acoustic neurinomas: diagnosis and treatment

Ramina¹,

Maniglia²,

Meneses³

et al. 1997

Arq. Neuro-Psiquiatr.

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-Sixteen patients with sellar tumors that were treated surgically and who had pre-operative somatotrophic and corticotrophic function deficits were submitted to pre-and early post-operative insulin tolerance tests (ITTs). Seven patients had non-functioning adenomas, 5 had prolactinomas, 3 had craniopharyngioma and 1 had cordoma of the clivus. All patients had macro-tumors and none received radiotherapy within the studied period. Seven patients had GH, 4 had Cortisol and 5 had both GH/cortisol function pre-operative deficit. Five patients with isolated GH, 4 with isolated Cortisol and 3 with both GH/cortisol deficiencies showed a postoperative functional recovery. New Cortisol secretion deficits were observed in 2 patients postoperatively and both required long-term steroid replacement. These data suggest that preoperative endocrine deficits may be reversible after surgical decompression of the sellar region and that new endocrine deficits are rarely seen after surgery. All such patients should be tested postoperatively from an endocrinological point of view to reevaluate the need for replacement therapies.KEY WORDS: pituitary tumors, transesphenoidal surgery, endocrine deficits.Evolução das funções somatotrófica e corticotrófica após cirurgia transesfenoidal em pacientes com tumores selares e deficits endócrinos pré-operatórios RESUMO -Dezesseis pacientes com tumores da região selar que foram tratados cirurgicamente e que possuíam deficits funcionais dos eixos somatotrófico ou corticotrófico foram submetidos a teste de tolerância à insulina pré-e pós-operatoriamente. Sete pacientes possuíam adenomas não-funcionantes, 5 possuíam prolactinomas, 3 craniofaringiomas e 1 possuía cordoma de clivus. Todos os pacientes possuíam macrotumores e nenhum deles foi submetido a radioterapia durante o período do estudo. Sete pacientes possuíam deficiência isolada do setor somatotrófico, 4 isolada do setor corticotrófico e 5 possuíam deficiência de ambos os setores. Cinco pacientes com deficiência isolada do setor somatotrófico, 4 com deficit isolado do setor corticotrófico e 3 com deficiência nos dois setores obtiveram melhora funcional pós-operatoriamente. Novos deficits do setor corticotrófico ocorreram em 2 pacientes, que necessitaram reposição de esteróides por longo prazo. Estes dados sugerem que deficits endócrinos pré-operatórios podem ser revertidos pela descompressão cirúrgica da região selar e que novos deficits causados pela cirurgia são raros. Estes pacientes devem ser retestados pós-operatoriamente do ponto de vista endócrino para se determinar a necessidade de terapia de reposição hormonal. PALAVRAS-CHAVE: tumores pituitários, cirurgia transesfenoidal, deficits endócrinos.Hypogonadotrophic hypogonadism and growth hormone deficiency (GHd) are the most common hormonal abnormalities in patients with tumors in the sellar region 1,18 .

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“…Muitos de seus efeitos no osso são mediados por IGF-1. O GH estimula a hidroxilação renal da 25-OH vit D3, absorção renal de cálcio e tem efeitos renais de retenção de fosfato (2,43). Outro provável mecanismo de ação do GH é através de aumento na carga mecânica imposta aos ossos, visto que o GH leva a maior massa e força muscular (5,44).…”

Section: Deficiência De Gh Em Adultos: Estudo Brasileirounclassified

“…A maioria dos estudos relata discreto declínio nos níveis séricos de T4 e elevação de T3 causada pelo aumento da conversão periférica do T4 para T3 (2,55). Neste estudo não encontramos mudanças significativas nos níveis de hormônios tireoideanos durante a reposição de GH.…”

Section: Deficiência De Gh Em Adultos: Estudo Brasileirounclassified

“…O S PRIMEIROS ESTUDOS CLÍNICOS sobre reposição de GH em adultos deficientes foram publicados no final da década de 80, após a introdução do GH recombinante (1,2). Subseqüentemente, foi demonstrado que adultos com deficiência de GH têm várias características em comum, incluindo mudanças na composição corporal (obesidade com predomínio de gordura visceral, redução na massa magra), alterações no metabolismo lipídico (aumento de colesterol total e LDL, redução de HDL e hipertrigliceridemia), no metabolismo glicídico (resistência insulínica), redução de massa e força musculares, redução da densidade mineral óssea (DMO) com maior prevalência de osteoporose e maior risco de fraturas, diminuição da capacidade ao exercício, pior qualidade de vida e mortalidade prematura, especialmente por doença cardiovascular (3).…”

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Deficiência de GH em adultos: resultados do estudo multicêntrico brasileiro

Conceição

Boguszewski

Meister

et al. 2003

Arq Bras Endocrinol Metab

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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.

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The Effects of Treatment with Recombinant Human Growth Hormone on Body Composition and Metabolism in Adults with Growth Hormone Deficiency

Cited by 1,292 publications

References 31 publications

Genetic and environmental correlations between obesity phenotypes and age at menarche

Genetic and environmental correlations between obesity phenotypes and age at menarche

Acoustic neurinomas: diagnosis and treatment

Deficiência de GH em adultos: resultados do estudo multicêntrico brasileiro

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