Endocrine Abstracts

Growth hormone deficiency (GHD) in adulthood has been associated with increased central adiposity, reduced lean body mass, increased cardiovascular risk, reduced bone mineral density with increased fracture risk and decreased quality of life. GH replacement might improve these alterations.

We evaluated the long-term metabolic effects of GH replacement on bone metabolism and body composition of 24 GHD patients (20 males, mean age 38±11 years, 20 adult onset). Patients were followed-up yearly for up to five years. Mean GH dose, normalizing IGF-1 was 0.4±0.2 mg/day. IGF-I levels normalized from −2.14±1.6 (mean S.D.±S.D.) to 0.11–0.87 mean S.D. values during five years of treatment. A significant increase in lean body mass and decrease in body fat mass was observed after one year – both 3% of body weight (P<0.05) – and this positive effect persisted. A significant increase in lumbar spine BMD was apparent from 2 years of treatment – after two years+4.9±3.4% (mean±S.E.M.) and after 5 years 6.1±6.2, P<0.05. Proximal femur BMD increased by 3.4±2.1% after 2 years and 6.3±2.6% after 5 years (P<0.05). Whole body BMD significantly increased after 3 years by 3±2.7% and slowly increased further to 4.2±3.7% after 5 years. We observed similar results when data of 56 patients from two centers were analyzed together.

In summary the long-term GH replacement in adults with GHD is effective in restoring IGF-I levels, favourably changes body composition and increases bone mineral density. These metabolic effects last after five years of treatment.