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Submitted on July 12, 2006
Accepted on January 26, 2007
Research Centre for Endocrinology and Metabolism (GG, B-ÅB, GJ, JS) Department of Clinical Nutrition (IB), Sahlgrenska University Hospital, Göteborg, Sweden
* To whom correspondence should be addressed. E-mail: Galina.Gotherstrom{at}medic.gu.se.
Context. Only a few studies have investigated the effects of growth hormone (GH) replacement in adults for more than 5 years.
Objective/Design/Patients. In a prospective, open-label, single-center study, the effects of 10-year GH replacement were determined. Eighty-seven consecutive patients (52 men and 35 women), with a mean age of 44.1 (range 22-74) years with adult onset GH deficiency (GHD) were included.
Results. The initial mean dose of GH (0.98 mg/day) was reduced during the study and at year ten was 0.47 mg/day. The mean insulin-like growth factor-I (IGF-I) SD score increased from -1.81 at baseline to 1.29 at study end. The absolute reduction in total body fat was transient. However, after correction for age and sex using a four-compartment model, the reduction in body fat was sustained during the 10-year study period. There was a sustained improvement in serum lipid profile and after 10 years, blood glycosylated hemoglobin (HbA1c) level was reduced. The treatment responses in IGF-I SD score, serum high density lipoprotein-cholesterol (HDL-C) level, and body composition as measured using dual energy X-ray absorptiometry (DEXA), were more marked in men whereas women had a more marked reduction in blood HbA1c level.
Conclusion. The effect on the absolute amount of body fat was seen early and was transient, which could be due to the normal aging of the patients. The effects on metabolic indices were detected later, but they were sustained and even progressive throughout the study period.
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