Journal of Clinical Endocrinology & Metabolism, Vol 80, 552-557, Copyright © 1995 by Endocrine Society

ARTICLES

Effect of growth hormone (hGH) replacement therapy on physical work capacity and cardiac and pulmonary function in patients with hGH deficiency acquired in adulthood

R Nass, RM Huber, V Klauss, OA Muller, J Schopohl and CJ Strasburger
Medical Clinic, Innenstadt University Hospital, Ludwig-Maximilians- Universitat, Munich, Germany.

The effects of 6 months of replacement therapy with recombinant human GH (hGH) on physical work capacity and cardiac structure and function were investigated in 20 patients with hGH deficiency of adult onset in a double blind, placebo-controlled trial. The GH dose of 12.5 micrograms/kg BW was self-administered daily sc. Oxygen consumption (VO2), CO2 production, and ventilatory volumes were measured during exercise on a bicycle spiroergometer. M-Mode echocardiography was performed using standard techniques. The VO2 max data, expressed per kg BW (mL/min.kg BW) showed a significant increase from 23.2 +/- 2.4 to 30.0 +/- 2.3 (P < 0.01) in the hGH-treated group, whereas the VO2 max data, expressed per lean body mass (milliliters per min/kg lean body mass) did not change significantly in either group. Maximal O2 pulse (milliliters per beat) increased significantly from 15.2 +/- 5.6 to 19.6 +/- 3.3 mL/beat (P < 0.01), but remained constant in the placebo group. The maximal power output (watts +/- SE) increased significantly (P < 0.01) from 192.5 +/- 13.5 to 227.5 +/- 11.5 in the hGH-treated group, but remained constant in the placebo group. Cardiac structure (left ventricular posterior wall, interventricular septum thickness, left ventricular mass, left ventricular end-systolic dimension, and left ventricular end-diastolic dimension) as well as echocardiographically assessed cardiac function did not change significantly after 6 months of treatment in either group. We conclude that hGH replacement in hGH-deficient adults improves oxygen uptake and exercise capacity. These improvements in pulmonary parameters might be due to an increase in respiratory muscle strength and partly to the changes in muscle volume per se observed during hGH replacement therapy. Furthermore, an increased cardiac output might contribute to the improvement in exercise performance during hGH treatment. According to our data, hGH replacement therapy leads to an improvement of exercise capacity and maximal oxygen uptake, but has no significant effect on cardiac structure.

This article has been cited by other articles:

				D S Olsson, M Buchfelder, S Schlaffer, B-A Bengtsson, K-E Jakobsson, G Johannsson, and A G Nilsson Comparing progression of non-functioning pituitary adenomas in hypopituitarism patients with and without long-term GH replacement therapy Eur. J. Endocrinol., November 1, 2009; 161(5): 663 - 669. [Abstract] [Full Text] [PDF]

				K. Goto, S. Doessing, R. H. Nielsen, A. Flyvbjerg, and M. Kjaer Growth Hormone Receptor Antagonist Treatment Reduces Exercise Performance in Young Males J. Clin. Endocrinol. Metab., September 1, 2009; 94(9): 3265 - 3272. [Abstract] [Full Text] [PDF]

				W. M. Widdowson and J. Gibney The Effect of Growth Hormone Replacement on Exercise Capacity in Patients with GH Deficiency: A Metaanalysis J. Clin. Endocrinol. Metab., November 1, 2008; 93(11): 4413 - 4417. [Abstract] [Full Text] [PDF]

				M. L. Hartman, A. Weltman, A. Zagar, R. L. Qualy, A. R. Hoffman, and G. R. Merriam Growth Hormone Replacement Therapy in Adults with Growth Hormone Deficiency Improves Maximal Oxygen Consumption Independently of Dosing Regimen or Physical Activity J. Clin. Endocrinol. Metab., January 1, 2008; 93(1): 125 - 130. [Abstract] [Full Text] [PDF]

				J. Gibney, M.-L. Healy, and P. H. Sonksen The Growth Hormone/Insulin-Like Growth Factor-I Axis in Exercise and Sport Endocr. Rev., October 1, 2007; 28(6): 603 - 624. [Abstract] [Full Text] [PDF]

				P. Marzullo, C. Marcassa, R. Campini, E. Eleuteri, A. Minocci, A. Sartorio, R. Vettor, A. Liuzzi, and G. Grugni Conditional Cardiovascular Response to Growth Hormone Therapy in Adult Patients with Prader-Willi Syndrome J. Clin. Endocrinol. Metab., April 1, 2007; 92(4): 1364 - 1371. [Abstract] [Full Text] [PDF]

				L. J. Woodhouse, A. Mukherjee, S. M. Shalet, and S. Ezzat The Influence of Growth Hormone Status on Physical Impairments, Functional Limitations, and Health-Related Quality of Life in Adults Endocr. Rev., May 1, 2006; 27(3): 287 - 317. [Abstract] [Full Text] [PDF]

				M. L. Healy, J. Gibney, C. Pentecost, P. Croos, D. L. Russell-Jones, P. H. Sonksen, and A. M. Umpleby Effects of High-Dose Growth Hormone on Glucose and Glycerol Metabolism at Rest and during Exercise in Endurance-Trained Athletes J. Clin. Endocrinol. Metab., January 1, 2006; 91(1): 320 - 327. [Abstract] [Full Text] [PDF]

				A. R. Hoffman, B. M. K. Biller, D. Cook, J. Baptista, B. L. Silverman, L. Dao, K. M. Attie, P. Fielder, T. Maneatis, B. Lippe, et al. Efficacy of a Long-Acting Growth Hormone (GH) Preparation in Patients with Adult GH Deficiency J. Clin. Endocrinol. Metab., December 1, 2005; 90(12): 6431 - 6440. [Abstract] [Full Text] [PDF]

				J. G. Esposito, S. G. Thomas, L. Kingdon, and S. Ezzat Anabolic growth hormone action improves submaximal measures of physical performance in patients with HIV-associated wasting Am J Physiol Endocrinol Metab, September 1, 2005; 289(3): E494 - E503. [Abstract] [Full Text] [PDF]

				A. Berggren, C. Ehrnborg, T. Rosen, L. Ellegard, B.-A. Bengtsson, and K. Caidahl Short-Term Administration of Supraphysiological Recombinant Human Growth Hormone (GH) Does Not Increase Maximum Endurance Exercise Capacity in Healthy, Active Young Men and Women with Normal GH-Insulin-Like Growth Factor I Axes J. Clin. Endocrinol. Metab., June 1, 2005; 90(6): 3268 - 3273. [Abstract] [Full Text] [PDF]

				J. G. Esposito, S. G. Thomas, L. Kingdon, and S. Ezzat Growth Hormone Treatment Improves Peripheral Muscle Oxygen Extraction-Utilization during Exercise in Patients with Human Immunodeficiency Virus-Associated Wasting: A Randomized Controlled Trial J. Clin. Endocrinol. Metab., October 1, 2004; 89(10): 5124 - 5131. [Abstract] [Full Text] [PDF]

				S. M. Harman and M. R. Blackman Hormones and Supplements: Do They Work?: Use of Growth Hormone for Prevention or Treatment of Effects of Aging J. Gerontol. A Biol. Sci. Med. Sci., July 1, 2004; 59(7): B652 - B658. [Abstract] [Full Text] [PDF]

				P. Maison, S. Griffin, M. Nicoue-Beglah, N. Haddad, B. Balkau, and P. Chanson Impact of Growth Hormone (GH) Treatment on Cardiovascular Risk Factors in GH-Deficient Adults: A Metaanalysis of Blinded, Randomized, Placebo-Controlled Trials J. Clin. Endocrinol. Metab., May 1, 2004; 89(5): 2192 - 2199. [Abstract] [Full Text] [PDF]

				S. G. Thomas, J. G. Esposito, and S. Ezzat Exercise Training Benefits Growth Hormone (GH)-Deficient Adults in the Absence or Presence of GH Treatment J. Clin. Endocrinol. Metab., December 1, 2003; 88(12): 5734 - 5738. [Abstract] [Full Text] [PDF]

				P. Maison and P. Chanson Cardiac Effects of Growth Hormone in Adults With Growth Hormone Deficiency: A Meta-Analysis Circulation, November 25, 2003; 108(21): 2648 - 2652. [Abstract] [Full Text] [PDF]

				Why start an adult on growth hormone? DTB, October 1, 2002; 40(10): 75 - 78. [Abstract] [Full Text] [PDF]

				W. L. Isley Growth Hormone Therapy for Adults: Not Ready for Prime Time? Ann Intern Med, August 6, 2002; 137(3): 190 - 196. [Abstract] [Full Text] [PDF]

				D. M. Cook Shouldn't Adults with Growth Hormone Deficiency Be Offered Growth Hormone Replacement Therapy? Ann Intern Med, August 6, 2002; 137(3): 197 - 201. [Abstract] [Full Text] [PDF]

				S. Ezzat, S. Fear, R.-C. Gaillard, C. Gayle, H. Landy, S. Marcovitz, T. Mattioni, S. Nussey, A. Rees, and E. Svanberg Gender-Specific Responses of Lean Body Composition and Non-Gender-Specific Cardiac Function Improvement after GH Replacement in GH-Deficient Adults J. Clin. Endocrinol. Metab., June 1, 2002; 87(6): 2725 - 2733. [Abstract] [Full Text] [PDF]

				A. Cittadini, A. Berggren, S. Longobardi, C. Ehrnborg, R. Napoli, T. Rosen, S. Fazio, K. Caidahl, B.-A. Bengtsson, and L. Sacca Supraphysiological Doses of GH Induce Rapid Changes in Cardiac Morphology and Function J. Clin. Endocrinol. Metab., April 1, 2002; 87(4): 1654 - 1659. [Abstract] [Full Text] [PDF]

				A. Colao, C. di Somma, R. Pivonello, A. Cuocolo, L. Spinelli, D. Bonaduce, M. Salvatore, and G. Lombardi The Cardiovascular Risk of Adult GH Deficiency (GHD) Improved after GH Replacement and Worsened in Untreated GHD: A 12-Month Prospective Study J. Clin. Endocrinol. Metab., March 1, 2002; 87(3): 1088 - 1093. [Abstract] [Full Text] [PDF]

				M. E. Molitch Diagnosis of GH Deficiency in Adults--How Good Do the Criteria Need to Be? J. Clin. Endocrinol. Metab., February 1, 2002; 87(2): 473 - 476. [Full Text] [PDF]

				W. M. Drake, S. J. Howell, J. P. Monson, and S. M. Shalet Optimizing GH Therapy in Adults and Children Endocr. Rev., August 1, 2001; 22(4): 425 - 450. [Abstract] [Full Text] [PDF]

				A. Colao, C. di Somma, A. Cuocolo, L. Spinelli, N. Tedesco, R. Pivonello, D. Bonaduce, M. Salvatore, and G. Lombardi Improved Cardiovascular Risk Factors and Cardiac Performance after 12 Months of Growth Hormone (GH) Replacement in Young Adult Patients with GH Deficiency J. Clin. Endocrinol. Metab., May 1, 2001; 86(5): 1874 - 1881. [Abstract] [Full Text]

				A. Sartorio, C. Lafortuna, and M. V. Narici Physical Performance in Growth Hormone- Deficient Adults J. Clin. Endocrinol. Metab., April 1, 2001; 86(4): 1839 - 1839. [Full Text]

				J.-L. Wang, N. Chinookoswong, S. Yin, and Z.-Q. Shi Calorigenic actions of leptin are additive to, but not dependent on, those of thyroid hormones Am J Physiol Endocrinol Metab, December 1, 2000; 279(6): E1278 - E1285. [Abstract] [Full Text] [PDF]

				Measures of Submaximal Aerobic Performance Evaluate and Predict Functional Response to Growth Hormone (GH) Treatment in GH-Deficient Adults J. Clin. Endocrinol. Metab., December 1, 1999; 84(12): 4570 - 4577. [Abstract] [Full Text]

				M. L. Vance and N. Mauras Growth Hormone Therapy in Adults and Children N. Engl. J. Med., October 14, 1999; 341(16): 1206 - 1216. [Full Text] [PDF]

				J. C. ter Maaten, H. de Boer, O. Kamp, L. Stuurman, and E. A. van der Veen Long-Term Effects of Growth Hormone (GH) Replacement in Men with Childhood-Onset GH Deficiency J. Clin. Endocrinol. Metab., July 1, 1999; 84(7): 2373 - 2380. [Abstract] [Full Text]

				Skeletal Muscle Dysfunction in Chronic Obstructive Pulmonary Disease . A Statement of the American Thoracic Society and European Respiratory Society Am. J. Respir. Crit. Care Med., April 1, 1999; 159(4): S2 - 40. [Full Text] [PDF]

				Y. J. H. Janssen, J. Doornbos, and F. Roelfsema Changes in Muscle Volume, Strength, and Bioenergetics during Recombinant Human Growth Hormone (GH) Therapy in Adults with GH Deficiency J. Clin. Endocrinol. Metab., January 1, 1999; 84(1): 279 - 284. [Abstract] [Full Text]

				S. M. Shalet, A. Toogood, A. Rahim, and B. M. D. Brennan The Diagnosis of Growth Hormone Deficiency in Children and Adults Endocr. Rev., April 1, 1998; 19(2): 203 - 223. [Abstract] [Full Text]

				P. V. Carroll, E. R. Christ the members of Growth Hormone Research Soci, B. A. Bengtsson, L. Carlsson, J. S. Christiansen, D. Clemmons, R. Hintz, K. Ho, Z. Laron, P. Sizonenko, et al. Growth Hormone Deficiency in Adulthood and the Effects of Growth Hormone Replacement: A Review J. Clin. Endocrinol. Metab., February 1, 1998; 83(2): 382 - 395. [Abstract] [Full Text]

				S. W. Lamberts, A. W. van den Beld, and A. van der Lely The Endocrinology of Aging Science, October 17, 1997; 278(5337): 419 - 424. [Abstract] [Full Text]

				A. F. Attanasio, S. W.J. Lamberts, A. M.C. Matranga, M. A. Birkett, P. C. Bates, N. K. Valk, J. Hilsted, B.-A. Bengtsson, and C. J. Strasburger Adult Growth Hormone (GH)-Deficient Patients Demonstrate Heterogeneity Between Childhood Onset and Adult Onset Before and During Human GH Treatment J. Clin. Endocrinol. Metab., January 1, 1997; 82(1): 82 - 88. [Abstract] [Full Text] [PDF]