ECE2024 Poster Presentations Pituitary and Neuroendocrinology (120 abstracts)
Effects of recombinant growth hormone treatment on metabolic fitness, body composition and echocardiographic parameters in a population of patients with overweight or obesity and adult GH deficiency
Maria Elena Spoltore 1 , Davide Masi 1 , Rebecca Rossetti 1 , Gabriele Veroi 1 , Maria Ignazia Curreli 1 , Mariangela Peruzzi 2 , Valentina Ventimiglia 1 , Giorgia Maria Baldazzi 1 , Elena Gangitano 1 , Mikiko Watanabe 1 , Stefania Mariani 1 , Lucio Gnessi 1 & Carla Lubrano 1
1Sapienza University of Rome, Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Rome, Italy; 2Sapienza University of Rome, Department of Clinical Internal, Anaesthesiological and Cardiovascular Sciences, Rome, Italy
Introduction: Adult growth hormone (GH) deficiency has been associated with the onset of sarcopenic obesity, reduced bone mineral density, and the progression of metabolic syndrome, often accompanied by the accumulation of ectopic fat at the epicardial level and changes in echocardiographic measures.
Objective and Design: This prospective pilot study aimed to assess the impact of recombinant human GH (rhGH) replacement therapy on glyco-metabolic parameters, body composition, and echocardiographic measures within a cohort of patients presenting both obesity/overweight and adult GH deficiency (aGHD). Inclusion criteria were as follows: age between 18 and 65, BMI ≥ 25 kg/m2, peak GH secretion post GHRH+arginine stimulation test < 4.2 ng/ml, and either partially or entirely empty sella turcica. Exclusion criteria included pregnancy/lactation, presence of active neoplasia, alcohol dependence, tobacco use, and medication potentially influencing the hypothalamic-pituitary axis.
Results: Our study involved 13 patients with obesity/overweight and aGHD (5 males, 8 females, mean age: 57.15 ± 6.29 years). Following enrollment, patients underwent rhGH replacement therapy and assessments were conducted at baseline (T0), after 6 months (T1), and after 12 months (T2), involving anthropometric, biochemical, DEXA-based body composition, and echocardiographic evaluations. At T1 and T2, notable reductions in waist/hip ratio (P=0.05), trunk fat (P=0.03), and trunk fat/low limb lean mass ratio (P=0.05) were observed, indicating substantial improvements in fat distribution. Concurrently, positive alterations were noted in cardio-metabolic risk markers, including reduced systolic blood pressure (P<0.003), total cholesterol/HDL cholesterol ratio (P<0.004), and increased HDL cholesterol levels (P=0.05). Moreover, a decrease in epicardial adipose tissue, indexed ventricular mass, interventricular septal thickness, and left ventricular posterior wall thickness was evident (P=0.04), with a tendency toward enhancement in left ventricular ejection fraction and telediastolic diameter.
Conclusion: The presence of GHD exacerbates cardiovascular risks in patients with overweight/obesity. Treatment with rhGH in our study cohort demonstrated improvements in adipose tissue distribution, lipid profiles, and notable effects on specific echocardiographic parameters. Notwithstanding, our study’s limitations encompass a small sample size and a 12-month follow-up duration. Future investigations with expanded cohorts and extended follow-ups up to 36 months are planned. If substantiated, these results could advocate for rhGH replacement therapy in aGHD individuals with obesity/overweight to mitigate cardiometabolic risks and enhance cardiac structure and function.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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