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

Endocrine Abstracts (2011) 26 P283

GH deficiency in cured acromegalic patients: metabolic effects of recombinant hGH replacement

C Giavoli1,2, E Verrua1,2, E Ferrante1,2, C L Ronchi1,2, E Profka1,2, M Arosio1,3, A Spada1,3 & P Beck-Peccoz1

1Department of Medical Sciences, University of Mian, Milan, Italy; 2Unit of Endocrinology and Diabetology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy; 3Ospedale San Giuseppe Multimedica, Milan, Italy.

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.

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