Endocrine Abstracts

Objective: To investigate long-term effects of GH replacement therapy.

Material and methods: Thirty-nine patients (mean age 52.5 years, 14 women) with adult-onset growth hormone deficiency (AOGHD), recruited from a randomized placebo-controlled crossover study of treatment with growth hormone (GH) and placebo for 9months each, were enrolled in an open prospective follow up study. GH replacement was given for additional thirty-three months and was individually dosed to obtain an IGF-1 concentration within the upper part of the normal range for age and sex.

Results: During treatment, IGF-1 increased significantly and reached target levels, P<0.001. The final mean dose was 0.88 (S.D.=0.60) mg/d for women and 0.56 (0.22) mg/d for men, a significant difference between genders, P=0.03. QoL was improved as assessed by HSCL-58 sum score – 7.4 (22.4), P=0.03 and AGDHA sum score −2.2 (6.0), P=0.03, increase in physical activity, P=0.05 and improvement in SF-36 dimension vitality, P=0.006. Bone mineral content and bone mineral density increased significantly, both in lumbar (L2–L4) spine, P=0.001 and P=0.007 respectively, and in total body, P<0.001 and P=0.01 respectively. Changes in body fat mass (BFM) and lean body mass (LBM) observed in the controlled part of the study was sustained with a reduction in BFM by −2.18 (4.87) kg, P=0.01 and an increase in LBM by 2.01 (3.25) kg, P=0,007. LDL-cholesterol was reduced – 0.6 (1.1) mmol/l, P=0.002, and HDL-cholesterol increased 0.2 (0.3) mmol/l, P<0.001. No changes were observed in total cholesterol, fasting triglycerides, HbA1c %, fasting plasma insulin and fasting plasma glucose.

Conclusions: Long-term replacement of low dose growth hormone in AOGHD induces favourable effects on QoL, bone and several metabolic parameters.