Introduction: Growth hormone (GH) is a lipolytic hormone with pleitropic metabolic functions. The effects of long-term GH substitution in pituitary insufficient patients with growth hormone deficiency (GHD) on lipid metabolism and bone mineralisation (BMD) have yet to be ascertained.
Methods: We measured fasting total cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides, glucose and insulin concentrations in 52 GHD on constant hormone replacement for pituitary insufficiency (21f/31m, median age 51.5 years (2782)). Twenty-two GHD were additionally on constant GH substitution (GH-Sub) for at least 2 years (median 10 years (242 years)). Thirty age- and BMI-matched GHD had not been substituted for at least 2 years (non-Sub). Five GH-Subs and 4 non-Subs received medical treatment for lipid metabolism (GH-Sub: 4 statine, 1 fibrate, non-Sub: 3 statine, 1 fibrate). One non-Sub was on bisphosponate therapy for treatment of osteoporosis. BMD was measured by Dual-Energy-X-Ray-Absorptiometry. Osteoporosis was defined according to the World-Health-Organization.
Results: Total cholesterol, LDL, HDL and triglycerides were not significantly different between GH-Sub and non-Sub (total cholesterol 214 mg/dl (162295) vs 205 mg/dl (149309), LDL 133 mg/dl (85218) vs 129 mg/dl (65218), HDL 57 mg/dl (3184) vs 48 mg/dl (1493), triglyceride 123 mg/dl (55292) vs 134 mg/dl (41923)). Glucose was significantly lower for GH-Sub than non-Sub (87 mg/dl (71103) vs non-Sub 89 mg/dl (71113), P<0.05), whereas insulin did not differ significantly (10 μE/ml (442) vs non-Sub 10 μE/ml (463)). Furthermore, BMD and T-scores did not differ significantly between the two groups (BMD: GH-Sub: 1.18 g/cm2 (0.971.39) vs 1.14 g/cm2 (0.921.32), T-score: GH-Sub: −0.3 (−2.42) vs −0.2 (−2.71.3)). The percentage of patients having osteopenia was higher in GH-Sub compared to non-Sub (36 vs 0%), but more non-Sub had significant osteoporosis (20 vs 7%).
Conclusion: Long-term GH substitution alone does not seem to significantly impact on lipid metabolism and BMD in patients with pituitary insufficiency.
25 - 29 Apr 2009
European Society of Endocrinology