Effects of recombinant human growth hormone (rhGH) administration on body composition and cardiovascular risk factors in
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RESEARCH
Open Access
Effects of recombinant human growth hormone (rhGH) administration on body composition and cardiovascular risk factors in obese adolescent girls Meghan Slattery1*, Miriam A Bredella2, Takara Stanley3, Martin Torriani2 and Madhusmita Misra1,3
Abstract Background: Obesity is associated with a relative deficiency of growth hormone, which is predictive of greater visceral fat and markers of cardiovascular risk. The study’s purpose was to use recombinant human growth hormone (rhGH) as a physiologic probe to assess the effects of reversing obesity-related GH deficiency on body composition, cardiovascular risk markers, and insulin resistance. Methods: 22 obese girls 13–21 years old were followed for a randomized 6-month trial of rhGH vs. placebo/no treatment. At baseline and 6-months, DXA was performed for body composition, MRI to measure visceral, subcutaneous and total adipose tissue (VAT, SAT and TAT), and fasting blood drawn for IGF-1, inflammatory cardiovascular risk markers [soluble intercellular adhesion molecule (sICAM), high sensitivity CRP], lipids and HbA1C. An oral glucose tolerance test (OGTT) was performed. Twelve girls completed the 6-month visit. Baseline and mean 6-month change were compared between the groups using the Student t-test and the relationship between variables was determined through multiple regression analysis. Results: After 6-months, the rhGH group maintained IGF-1 levels, and had decreases in total cholesterol (p = 0.03), sICAM-1 (p = 0.04) and HbA1C (p = 0.03) compared to placebo/no treatment. The rhGH group trended towards greater decreases in LDL and 2-hour OGTT glucose. Glucose tolerance did not worsen with rhGH administration. Conclusions: Administering rhGH in small doses is able to stabilize IGF-1 levels in obesity. We have also shown that rhGH administration leads to an improvement in some markers of cardiovacular risk with without adversely affecting glucose tolerance. Trial registration: Clinical Trial Registration Number: NCT01169103. Keywords: Adolescents, Growth hormone, Visceral fat, Body composition, Females, Inflammatory markers
Background Obesity, a pressing global issue, is characterized by diminished growth hormone (GH) secretion in adults [1,2] and adolescents [3], with decreased frequency and amplitude of GH secretory bursts [4]. Pathological GH deficiency is characterized by a high risk cardiovascular profile [5-8], and similarly, in obese individuals, relatively low GH levels are associated with higher visceral fat [3], which in turn predisposes individuals to components of * Correspondence: [email protected] 1 Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, BUL 457B, Neuroendocrine Unit, 55 Fruit Street, MGH, Boston, MA 02114, USA Full list of author information is available at the end of the article
the metabolic syndrome [9,10], including hyperlipidemia [10,11] and insulin resistance [10,12]. While GH replacement in children with pathologic GH deficiency causes a decrease in visceral adiposity [13],
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