scholarly journals Growth Hormone Replacement Therapy Improves Body Composition and Increases Bone Metabolism in Elderly Patients with Pituitary Disease1

2000 ◽  
Vol 85 (11) ◽  
pp. 4104-4112 ◽  
Author(s):  
Rita Fernholm ◽  
Margareta Bramnert ◽  
Erik Hägg ◽  
Agneta Hilding ◽  
David J. Baylink ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Body Composition ◽  
Side Effects ◽  
Replacement Therapy ◽  
Bone Metabolism ◽  
Mineral Density ◽  
Normal Range ◽  
Gh Treatment ◽  
Gh Replacement ◽  
Igf I

Although a specific GH deficiency (GHD) syndrome in the adult and the response to GH replacement therapy are well recognized, there are few data available on the effect of GH replacement therapy in elderly GH-deficient patients. We studied the effect of GH therapy on body composition and bone mineral density measured by dual energy x-ray absorptiometry, markers for bone metabolism, insulin-like growth factors (IGFs), and IGF-binding proteins (IGFBPs) in 31 patients (6 women and 25 men; aged 60–79 yr; mean, 68 yr) with multiple pituitary hormone deficiencies. The GH response to arginine or insulin was below 3 μg/L (9 mU/L) in all subjects. They were randomized to GH (Humatrope, Eli Lilly & Co.) or placebo for 6 months, followed by 12 months of open treatment. The dose was 0.05 IU/kg·week for 1 month, and after that it was 0.1 IU/kg·week divided into daily sc injections (0.75–1.25 IU/day). There were no changes in any of the measured variables during placebo treatment. GH treatment normalized serum IGF-I in a majority of the patients and increased IGFBP-3 and -5 as well as IGFBP-4 and IGF-II to values within normal range. Lean body mass was increased, and the increase at 6 and 12 months correlated with the increase in IGF-I (r = 0.46; P = 0.010 and r = 0.54, respectively; P = 0.003). GH treatment caused a modest, but highly significant, reduction of total body fat. Mean bone mineral density was not different from that in healthy subjects of the same age and did not change during the observation period. Markers for bone formation (bone-specific alkaline phosphatase activity, osteocalcin, and procollagen I carboxyl-terminal peptide in serum) increased within the normal range, and levels were sustained throughout the study. The bone resorption marker (pyridinoline in urine) was significantly elevated for 12 months. Side-effects were mild, mostly attributed to fluid retention. In two patients with normal glucose tolerance at the start of the study, pathological glucose tolerance occurred in one patient and was impaired in one. In conclusion, elderly patients with GHD respond to replacement therapy in a similar manner as younger subjects, with an improvement in body composition and an increase in markers for bone metabolism. Side-effects are few, and elderly GHD patients can be offered treatment. As long-term risks are unknown, GH doses should be titrated to keep IGF-I within the age-related physiological range.

scholarly journals Growth hormone treatment of osteoporotic postmenopausal women - a one-year placebo-controlled study

1999 ◽  
pp. 390-399 ◽  
Author(s):  
M Saaf ◽  
A Hilding ◽  
M Thoren ◽  
S Troell ◽  
K Hall
Keyword(s):  
Bone Mineral Density ◽  
Growth Hormone ◽  
Side Effects ◽  
Femoral Neck ◽  
Bone Markers ◽  
Controlled Study ◽  
Mineral Density ◽  
Gh Treatment ◽  
Igf I ◽  
One Year

OBJECTIVES: To study the effect of 12 months of growth hormone (GH) treatment on bone markers, bone mineral density (BMD), lean body mass (LBM) and body fat mass (BF) in postmenopausal osteoporotic women. DESIGN: Sixteen patients were randomised to a double-blind randomised placebo-controlled one-year study with daily s.c. injections of GH or placebo. After the first year 14 patients (8 placebo treated, 6 GH treated) were recruited to GH treatment during the second year. All patients were also supplemented with 0.5 g calcium per oral. METHODS: Bone mineral density and body composition were assessed by dual energy X-ray absorptiometry. Biochemical bone markers were analysed by RIA or HPLC techniques. Diurnal GH profiles were performed with continuous venous blood sampling. RESULTS: Sixteen patients started in the placebo-controlled study. In all, twelve patients completed one year and only four patients completed two years of GH treatment. At baseline 3 patients had serum insulin-like growth factor-I (S-IGF-I) levels below -2 S.D. for age. Maximal diurnal GH levels tended to correlate negatively with S-IGF-I (P=0.076). S-IGF-I was unrelated to BMD. Serum IGF-binding protein-1 (S-IGFBP-1) correlated negatively with femoral neck BMD (r=-0.61, P=0.012). The intended GH dose of 0.05U/kg/day or a maximum of 3U/day s.c. was reduced to 0.024+/-0.004U/kg/day, equal to 0.5-2.7U/day due to frequent side effects, and four patients were excluded. After one year of GH treatment BF increased slightly, LBM and BMD in total body and lumbar spine were unchanged but femoral neck BMD had decreased 3.4+/-1.6% (P<0.05). The mean S-IGF-I increase was 32% (range -38-138%). Mean levels of the bone formation markers S-osteocalcin and S-procollagen type I propeptide increased maximally by 88 and 36% respectively after 9-12 months while the bone resorption markers were unchanged. In the placebo-treated group there were no significant alterations. CONCLUSIONS: The effects on S-IGF-I, bone markers and LBM were small although GH-related side effects were common. The reason for this apparent partial resistance to the anabolic effects of GH is not clear but nutritional deficits may be involved. Assessment of the effects of GH on bone mass and fracture rate requires longer study periods than one year.

Body composition and adipokines influence upon bone mineral density and bone metabolism in renal transplant receivers

2020 ◽  
Author(s):  
Anca Matei ◽  
Stefana Bilha ◽  
Daniela Constantinescu ◽  
Petru Cianga ◽  
Adrian Covic ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Body Composition ◽  
Renal Transplant ◽  
Bone Metabolism ◽  
Bone Mineral ◽  
Mineral Density

scholarly journals The Effects of Growth Hormone Treatment on Bone Mineral Density and Body Composition in Girls with Turner Syndrome

2006 ◽  
Vol 91 (11) ◽  
pp. 4302-4305 ◽  
Author(s):  
Mim Ari ◽  
Vladimir K. Bakalov ◽  
Suvimol Hill ◽  
Carolyn A. Bondy
Keyword(s):  
Bone Mineral Density ◽  
Body Composition ◽  
Turner Syndrome ◽  
Lean Body Mass ◽  
Body Mass ◽  
Bone Mineral ◽  
Bone Age ◽  
Treated Group ◽  
Mineral Density ◽  
Gh Treatment

Abstract Background: Many girls with Turner syndrome (TS) are treated with GH to increase adult height. In addition to promoting longitudinal bone growth, GH has effects on bone and body composition. Objective: The objective was to determine how GH treatment affects bone mineral density (BMD) and body composition in girls with TS. Method: In a cross-sectional study, we compared measures of body composition and BMD by dual energy x-ray absorptiometry, and phalangeal cortical thickness by hand radiography in 28 girls with TS who had never received GH and 39 girls who were treated with GH for at least 1 yr. All girls were participants in a National Institutes of Health (NIH) Clinical Research Center (CRC) protocol between 2001 and 2006. Results: The two groups were similar in age (12.3 yr, sd 2.9), bone age (11.5 yr, sd 2.6), and weight (42.8 kg, sd 16.6); but the GH-treated group was taller (134 vs. 137 cm, P = 0.001). The average duration of GH treatment was 4.2 (sd 3.2) yr (range 1–14 yr). After adjustment for size and bone age, there were no significant differences in BMD at L1–L4, 1/3 radius or cortical bone thickness measured at the second metacarpal. However, lean body mass percent was higher (P &lt; 0.001), whereas body fat percent was lower (P &lt; 0.001) in the GH-treated group. These effects were independent of estrogen exposure and were still apparent in girls that had finished GH treatment at least 1 yr previously. Conclusions: Although GH treatment has little effect on cortical or trabecular BMD in girls with TS, it is associated with increased lean body mass and reduced adiposity.

Effects of 12-month GH treatment on bone metabolism and bone mineral density in adults with adult-onset GH deficiency

2001 ◽  
Vol 24 (4) ◽  
pp. 224-230 ◽  
Author(s):  
Alessandro Sartorio ◽  
S. Ortolani ◽  
E. Galbiati ◽  
G. Conte ◽  
V. Vangeli ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Metabolism ◽  
Bone Mineral ◽  
Gh Deficiency ◽  
Adult Onset ◽  
Mineral Density ◽  
Gh Treatment

scholarly journals Relationships of dietary fat, body composition, and bone mineral density in inbred mouse strain panels

2008 ◽  
Vol 33 (1) ◽  
pp. 26-32 ◽  
Author(s):  
Renhua Li ◽  
Karen L. Svenson ◽  
Leah Rae B. Donahue ◽  
Luanne L. Peters ◽  
Gary A. Churchill
Keyword(s):  
Bone Mineral Density ◽  
Body Composition ◽  
Bone Mineral ◽  
Inbred Mouse ◽  
Inbred Strains ◽  
Dietary Factors ◽  
Equation Modeling ◽  
Caloric Content ◽  
Mineral Density ◽  
Igf I

Laboratory inbred mouse strains show a broad range of variation in phenotypes, such as body composition, bone mineral density (BMD), plasma leptin, and insulin-like growth factor I (IGF-I), and thus provide a basis for the study of associations among them. We analyzed these phenotypes in male and female mice from 43 inbred strains fed on a high-fat (30% caloric content) diet and from 30 inbred strains fed on a low-fat (6%) diet. Structural equation modeling of these data reveals that the relationship of body fat content and areal BMD is altered by dietary factors and genotypes. Sex has no net effect on areal BMD, but after accounting for body mass difference females have higher areal BMD. Leptin is affected by relative fat mass and has no net effect on areal BMD. IGF-I has a direct effect on areal BMD.

scholarly journals Changes in Bone Mineral Density, Body Composition, and Lipid Metabolism during Growth Hormone (GH) Treatment in Children with GH Deficiency1

1997 ◽  
Vol 82 (8) ◽  
pp. 2423-2428 ◽  
Author(s):  
Annemieke M. Boot ◽  
Melanie A. M. J. Engels ◽  
Geert J. M. Boerma ◽  
Eric P. Krenning ◽  
Sabine M. P. F. de Muinck Keizer-Schrama
Keyword(s):  
Bone Mineral Density ◽  
Growth Hormone ◽  
Body Composition ◽  
Lipid Metabolism ◽  
Bone Mineral ◽  
Mineral Density ◽  
Gh Treatment

scholarly journals One year of GH replacement therapy with a fixed low-dose regimen improves body composition, bone mineral density and lipid profile of GH-deficient adults

2005 ◽  
Vol 152 (1) ◽  
pp. 67-75 ◽  
Author(s):  
Cesar L Boguszewski ◽  
Ludimyla H F Meister ◽  
Daniele C T Zaninelli ◽  
Rosana B Radominski
Keyword(s):  
Bone Mineral Density ◽  
Insulin Resistance ◽  
Body Composition ◽  
Low Dose ◽  
Ldl Cholesterol ◽  
Resistance Index ◽  
Mineral Density ◽  
Insulin Resistance Index ◽  
Igf I ◽  
One Year

Objective: We have studied the effects on body composition and metabolism of a fixed low dose of growth hormone (GH), 0.6 IU (0.2 mg)/day, administered for 12 months to GH-deficient (GHD) adults. Design and methods: Prospective open-label study, using 18 GHD patients (11 women, 7 men; aged 21–58 years). All investigations were performed at baseline and after 12 months. Body composition was determined by dual energy X-ray absorptiometry. Results: Total body fat decreased (−1.74±2.87%) and lean body mass (LBM) increased (1.27±2.08 kg) after therapy (P < 0.05). Changes in truncal fat did not reach statistical significance, but a decrease varying from 0.72 to 2.78 kg (1 to 8.7%) was observed in 13 (72%) patients. Bone mineral density (BMD) increased at lumbar spine, total femur and femoral neck (P < 0.05). Levels of total and low-density lipoprotein (LDL)-cholesterol were lower after therapy (P < 0.05), and their changes were directly associated with values at baseline. Insulin levels increased and the insulin resistance index worsened at 12 months (P < 0.05). Median IGF-I s.d. score was −4.30 (range, −11.03 to −0.11) at baseline and −1.73 (range, −9.80 to 2.26) at 12 months. Normal age-adjusted IGF-I levels were obtained with therapy in 5 of 11 patients who had low IGF-I levels at baseline. Changes in IGF-I levels were not correlated with any biological end point, except changes in LBM (r = 0.53, P = 0.02). Side effects were mild and disappeared spontaneously. Conclusions: One-year of a fixed low-dose GH regimen in GHD adults resulted in a significant reduction in body fat, total cholesterol and LDL-cholesterol, and a significant increase in LBM and BMD at lumbar spine and femur, regardless of normalization of IGF-I levels. This regimen led to an elevation of insulin levels and a worsening of the insulin resistance index.

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