Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2012) 29 S29.2

ICEECE2012 Symposia Are we ready for novel therapies in obesity? (3 abstracts)

Growth hormone replacement and metabolic syndrome in GH deficient adults

D. Clemmons


University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.


There is an increased prevalence of metabolic syndrome in patients with severe GH deficiency. Prior studies used different criteria to define metabolic syndrome but in spite of this limitation, several studies indicate that GH therapy improves many of these parameters. The variable that shows the greatest improvement is waist circumference. Some studies show improvement in both systolic and diastolic blood pressure and in HDL cholesterol. Definitive evidence of decreased levels of triglycerides has not been forthcoming. GH results in minimal changes in adiponectin, leptin and resistin. The changes that occur in glucose metabolism are clearly dependent on GH dose. A low dose, e.g. 0.1 mg/day, improves glucose utilization but in studies wherein the entire range of GH doses was utilized, fasting glucose increased in initially 23% and then returned toward normal in all but 11% of patients. Only 6% of patients developed evidence of diabetes mellitus and this also tended to improve over time. Although GH administration clearly increases insulin resistances, most patients do not develop impaired fasting glucose or diabetes. In summary, the prevalence of the characteristic features of the metabolic syndrome is increased in GH deficiency. Institution of GH therapy is likely to improve waist circumference and in many patients it increases HDL. The effects on triglycerides and blood pressure are variable. Some lack of consistency may be due to patient selection and GH dosage. The effects on glucose metabolism are complex and involve increasing insulin resistance and decreasing visceral adiposity. The combined effect of these two changes results in maintenance of glucose homeostasis in most patients although a small subset may develop impaired fasting glucose or overt diabetes which requires modification of dosage. Whether changes in these parameters of metabolic syndrome will result in a benefit in terms of altering cardiovascular mortality has not been definitively determined.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

Volume 29

15th International & 14th European Congress of Endocrinology

European Society of Endocrinology 

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