ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2008) 16 OC1.3

Limited effects of growth hormone replacement in adults with growth hormone deficiency after treatment for acromegaly

Agatha van der Klaauw1, Jeroen Bax2, Marcel Stokkel3, Gabe Bleeker2, Ferdinand Roelfsema1, Johannes Smit1, Johannes Romijn1 & Alberto Pereira1


1Department of Endocrinology and Metabolism, Leiden University Medical Center, Leiden, The Netherlands; 2Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; 3Department of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands.


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.

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