Background: GH deficiency (GHD) may occur in about 60% of acromegalics treated and cured by surgery or radiotherapy. Effects of GH replacement have not yet been extensively studied in such a patients.
Aim: To investigate whether rhGH replacement improve metabolic parameters in acromegalic patients who become GHD.
Patients and methods: Forty GHD patients (mean age (S.D.): 48±10, BMI 27±3 kg/m2) were evaluated: 8 were acromegalics treated with rhGH (Group A: 5F&3M), whereas 12 acromegalics who refused treatment (Group B: 8F&4M) and 20 subjects with non-functioning pituitary adenoma on rhGH (Group C: 10F&10M) served as controls. BMI, body fat (BF%), waist circumference, IGF1 levels, glucose metabolism and lipid profile were assessed at the time of GHD diagnosis, after 12 and 36 months of rhGH treatment (mean rhGH dose 0.28±0.02 mg/day).
Results: At baseline Group B showed higher IGF1 levels than Groups A and C (153±38 vs 90±27 and 80±41 ng/ml respectively, P=0.001), and higher post-OGTT glucose levels than group A (127±34 vs 90±32 mg/dl, P=0.05), while no difference among Groups was recorded for the other parameters. After 12 months, IGF1 levels significantly increase in group A and C, remaining in the middle-upper part of the normal range. A decrease in BF% (from 36.3±5.2 to 31.7±2.4 and from 33±9 to 30±9 in Group A and C respectively, P<0.01) and total-cholesterol (from 252±50 to 203±57 and from 261±56 to 209±51 mg/dl in Group A and C respectively, P=0.04) was observed. In Group A fasting and post-OGTT glucose levels, HbA1c and HOMA did not change on rhGH. No side effects were recorded.
Conclusions: In GHD acromegalics, rhGH improved body composition and lipid profile, without deterioration of glucose tolerance. GH replacement should be considered in these patients, as in patients with GHD from other causes.
30 Apr - 04 May 2011
European Society of Endocrinology