Growth hormone deficiency (GHD) can occur after treatment for acromegaly. It is unclear whether treatment with recombinant human growth hormone (rhGH) in these patients is beneficial. Patients were randomized to either 1 year of rhGH replacement (n=10) or placebo followed by rhGH replacement for 1 year (delayed rhGH treatment, n=6). Sixteen patients (8 men, mean age 56 years) with GHD after treatment for acromegaly were studied. Study parameters were assessed at baseline and after 1 year of placebo (n=6, delayed treatment) and of rhGH replacement (n=16). The study parameters were: cardiac function, body composition, bone mineral density (BMD), fasting concentrations of lipids, glucose, insulin, C-peptide, PINP and β crosslaps, and quality of life using 4 different questionnaires (HADS, MFI-20, NHP and QoL-AGDHA). During 1 year of placebo (n=6), insulin concentrations decreased. In addition, left ventricular systolic function (fractional shortening and ejection fraction) decreased. Bone mineral density at the left hip decreased. Replacement with rhGH induced an increase of IGF-1 levels from 14.5±6.4 nmol/l to 20.5±6.5 nmol/l (n=16, P=0.001). However, rhGH did not alter any of the parameters of cardiac function, lipid and glucose metabolism, body composition or QoL. PINP and β crosslaps levels increased (P=0.005 and P=0.021, resp.), paralleled by a small but significant decrease in BMD of the left and right hip during rhGH replacement. In this trial, no beneficial effects of rhGH replacement in adults with GHD after treatment for acromegaly on cardiac function, lipid and glucose metabolism, body composition, bone mineral density or QoL could be observed.
03 - 07 May 2008
European Society of Endocrinology