GH replacement improves quality of life and metabolic parameters in cured acromegalic patients with growth hormone deficiency.

Abstract

OBJECTIVE:

Effects of GH replacement in patients with GH deficiency (GHD) after a cure for acromegaly so far have been poorly studied, although its prevalence among acromegalic patients may reach the 60%. The aim of the study was to evaluate whether metabolic parameters and quality of life are improved by GH replacement in patients with prior acromegaly and severe GHD.

DESIGN AND METHODS:

This was a prospective study on 42 GHD subjects [22 men, mean age (sd): 48 ± 10]: 10 acromegalics treated with recombinant human GH (group A), 12 acromegalics who refused treatment (group B), and 20 subjects operated for nonfunctioning pituitary adenoma on recombinant human GH (group C). Serum IGF-I levels, lipid profile, glucose levels (fasting and after an oral glucose tolerance test), glycosylated hemoglobin, insulin resistance (homeostasis model assessment insulin resistance index), anthropometric parameters (body mass index, waist circumference, body composition), and quality of life (Questions on Life Satisfaction-Hypopituitarism Z-scores) were evaluated at baseline and after 12 and 36 months.

RESULTS:

At baseline, group B showed higher IGF sd score than group A and C, as well as better quality of life and higher post-oral glucose tolerance test glucose levels than group A. After 12-months, similarly in group A and C, the IGF-I sd score significantly increased, and body composition and lipid profile improved, without deterioration of glucose tolerance. Quality of life significantly improved too, and the baseline difference between group A and B disappeared. Results were confirmed after 36 months.

CONCLUSIONS:

In GHD acromegalic patients, GH therapy improved body composition, lipid profile, and quality of life as in patients with GHD due to nonfunctioning pituitary adenoma, without negative effects on glucose metabolism. GH replacement therapy should be considered in these patients, as in patients with GHD from other causes.

• Authors: Claudia Giavoli, Eriselda Profka, Elisa Verrua, Cristina L Ronchi, Emanuele Ferrante, Silvia Bergamaschi, Elisa Sala, Elena Malchiodi, Andrea G Lania, Maura Arosio, Bruno Ambrosi, Anna Spada, Paolo Beck-Peccoz
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 97 Issue 11 Pg. 3983-8 (Nov 2012) ISSN: 1945-7197 [Electronic] United States
• PMID: 22904173 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Blood Glucose
• Lipids
• Recombinant Proteins
• Human Growth Hormone
• Insulin-Like Growth Factor I

Topics

• Acromegaly (blood, drug therapy, psychology, surgery)
• Adult
• Blood Glucose (metabolism)
• Female
• Hormone Replacement Therapy (psychology)
• Human Growth Hormone (deficiency, therapeutic use)
• Humans
• Insulin-Like Growth Factor I (metabolism)
• Lipids (blood)
• Male
• Middle Aged
• Prospective Studies
• Quality of Life (psychology)
• Recombinant Proteins (therapeutic use)
• Treatment Outcome