Study of Lipid Profiles levels in Iraqi children with GH Deficiency Before and after 6 Months GH Replacement Therapy

Abstract Introduction/Objective The aim of this study was to investigate the effects of GH administration on basic coagulation parameters: PT, aPTT and fibrinogen concentrations in adult GHD patients before and during one year of GH replacement. Methods Twenty-one adult patients with severe GHD (mean age +/- SE: 38.6 +/- 2.8 years) were included in this hospital based, prospective, interventional study. All patients were treated with rhGH for 12 months (GH dose: 0.4 mg/day for male and 0.6 mg/day for female patients). IGF-1 concentrations were determined using RIA-INEP kits. Basic coagulation tests, i.e. aPTT and fibrinogen concentrations, were measured before and after 3, 6 and 12 months of treatment with rhGH. Control values were obtained from fourteen “healthy” subjects matched by age, sex and body mass index (BMI). Results At baseline, we observed no significant differences in PT, aPTT and fibrinogen values between GHD and healthy subjects. IGF-1 concentrations increased significantly within 3 months of GH therapy (8.2 +/- 1.5 vs. 24.2 +/- 2.9 nmol/l, p <0.05) and remained stable thereafter. A significant increase in PT values, which was more pronounced in female subjects, was noted after 6 and 12 months of treatment with GH. aPTT values increased significantly after 12 months of treatment only in male patients (28.8 +/- 4.6 vs. 39.7 +/- 2.1 s.; p <0.05). No significant changes in fibrinogen concentrations were found during the study. Conclusion Twelve months of GH replacement therapy led to a significant increase in PT and aPTT values in adult GHD patients, while fibrinogen concentrations did not change. Changes in PT were more pronounced in female GHD patients, while an increase in aPTT values was observed only in male patients with GHD. The clinical significance of these changes needs further evaluation.

Download Full-text

Utility of P300 auditory event related potential latency in detecting cognitive dysfunction in growth hormone (GH) deficient patients with Sheehan's syndrome and effects of GH replacement therapy

Acta Endocrinologica ◽

10.1530/eje.0.1500153 ◽

2004 ◽

pp. 153-159 ◽

Cited By ~ 33

Author(s):

A Golgeli ◽

F Tanriverdi ◽

C Suer ◽

C Gokce ◽

C Ozesmi ◽

...

Keyword(s):

Growth Hormone ◽

Cognitive Function ◽

Replacement Therapy ◽

Patient Group ◽

Gh Deficiency ◽

Event Related Potential ◽

Sheehan’S Syndrome ◽

Gh Replacement ◽

Igf I ◽

Sheehan's Syndrome

OBJECTIVE: Impaired cognitive function has been demonstrated in adults with growth hormone (GH) deficiency (GHD) by using different neuropsychological tests. Despite several studies, present knowledge about the impact of GHD and GH replacement therapy (GHRT) on cognitive function is limited. P300 event-related potential (ERP) application is a well-established neurophysiological approach in the assessment of cognitive functions including the updating of working memory content and the speed of stimulus evaluation. GHD is a well-known feature of Sheehan's syndrome and cognitive changes due to GHD and the effects of GHRT remain to be clarified. The present study was designed to investigate the effects of GHD and 6 months of GHRT on cognitive function in patients with Sheehan's syndrome by using P300 latency. DESIGN AND METHODS: The study comprised 14 patients with Sheehan's syndrome (mean age, 49.5+/-7.8 years) and 10 age-, education- and sex-matched healthy controls. With hormone replacement therapy, basal hormone levels other than GH were stable before enrollment and throughout the GHRT. The diagnosis of GH deficiency was established by insulin-tolerance test (ITT), and mean peak level of GH in response to insulin hypoglycemia was 0.77+/-0.35 mIU/l. Treatment with GH was started at a dose of 0.45 IU (0.15 mg)/day in month 1, was increased to 0.9 IU (0.30 mg)/day in month 2 and was maintained at 2 IU (0.66 mg)/day. Initially baseline auditory ERPs in patients and controls were recorded at frontal (Fz), central (Cz), and parietal (P3 and P4) electrode sites. In the patient group, ERPs were re-evaluated after 6 months of GH replacement therapy. During each session P300 amplitude and latency were measured. RESULTS: Mean serum insulin-like growth factor-I (IGF-I) concentration in the patient group before GHRT was 23+/-13 ng/ml. After 6 months of GH therapy mean IGF-I significantly increased to an acceptable level, 234+/-71 ng/ml (P<0.05). The mean latencies (at all electrode sites) of the patients before GHRT were found to be significantly prolonged when compared with those of normal controls (P<0.05). After 6 months of GHRT mean P300 latencies (at all electrode sites) were decreased significantly when compared with latencies before treatment (P<0.05). CONCLUSIONS: The present study, using P300 ERP latencies, therefore suggests an impairment of cognitive abilities due to severe GHD in patients with Sheehan's syndrome and an improvement of cognitive function after 6 months of physiological GHRT. Moreover, this was a novel application of P300 ERP latencies in cognitive function detection in patients with GHD. Further studies with different patient groups need to be done to assess the clinical use of this electrophysiological method in the diagnosis of cognitive dysfunction due to GHD.

Download Full-text

Growth Hormone (GH) Replacement Therapy in Adult-Onset GH Deficiency: Effects on Body Composition in Men and Women in a Double-Blind, Randomized, Placebo-Controlled Trial

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2003-030346 ◽

2004 ◽

Vol 89 (5) ◽

pp. 2048-2056 ◽

Cited By ~ 119

Author(s):

Andrew R. Hoffman ◽

Joyce E. Kuntze ◽

Joyce Baptista ◽

Howard B. A. Baum ◽

Gerhard P. Baumann ◽

...

Keyword(s):

Growth Hormone ◽

Body Composition ◽

Replacement Therapy ◽

Gh Deficiency ◽

Controlled Trial ◽

Adult Onset ◽

Double Blind ◽

Men And Women ◽

Gh Replacement

Download Full-text

Autonomic nervous system and cardiovascular risk assessment during one year of growth hormone (GH) replacement therapy in adults with GH deficiency

HORMONES ◽

10.14310/horm.2002.1510 ◽

2014 ◽

Author(s):

Mara Boschetti ◽

Massimo Casu ◽

Sara Moretti ◽

Claudia Teti ◽

Valeria Albanese ◽

...

Keyword(s):

Risk Assessment ◽

Growth Hormone ◽

Nervous System ◽

Cardiovascular Risk ◽

Autonomic Nervous System ◽

Replacement Therapy ◽

Gh Deficiency ◽

Cardiovascular Risk Assessment ◽

Gh Replacement ◽

One Year

Download Full-text

Hepatic steatosis, GH deficiency and the effects of GH replacement: a Liverpool magnetic resonance spectroscopy study

Acta Endocrinologica ◽

10.1530/eje-12-0002 ◽

2012 ◽

Vol 166 (6) ◽

pp. 993-1002 ◽

Cited By ~ 24

Author(s):

Chris J Gardner ◽

Andrew J Irwin ◽

Christina Daousi ◽

Ian A McFarlane ◽

Franklin Joseph ◽

...

Keyword(s):

Magnetic Resonance ◽

Visceral Fat ◽

Gh Deficiency ◽

Liver Fat ◽

Resonance Spectroscopy ◽

Alcoholic Fatty Liver ◽

Magnetic Resonance Spectroscopy Study ◽

Gh Replacement ◽

Before And After ◽

Imaging And Spectroscopy

ObjectiveNon-alcoholic fatty liver disease (NAFLD) is reported to be more common in patients with GH deficiency (GHD) than in the general population. We aimed to determine: i) liver fat in patients with GHD compared with age and body mass index (BMI)-matched controls; and ii) effect of 6 months of GH replacement (GHR) on liver fat.Participants and methodsThe study included 28 GHD patients and 24 controls. 12 patients were studied before and after 6 months of GHR. Anthropometry, liver enzymes and lipid profiles were measured, and body composition and intrahepatocellular lipid (IHCL) were determined by magnetic resonance imaging and spectroscopy.ResultsAge and BMI (median (inter-quartile range)) of patients and controls were 52.6 (14) vs 52.6 (12) years (P=0.9) and 27.8 (24.7, 34.7) vs 27.9 (25.1, 32.1) kg/m2(P=0.9). IGF1 was lower in the patients (11.5 vs 16.0 nmol/l,P=0.002). There was no difference in liver transaminases, lipids or IHCL between patients and controls (2.8 (1.3, 8.6) vs 5.0 (1.5, 12.7),P=0.72), despite significantly higher visceral fat in GHD patients. Thirty-two percent of patients and 50% of controls had NAFLD (defined as IHCL >5.6%), and the relationship between IHCL and BMI was the same in each group. GHR significantly reduced abdominal subcutaneous and visceral fat in all patients; however, GHR did not reduce liver fat.ConclusionsNAFLD is equally common in patients with GHD and matched controls. GHR is associated with a hierarchical reduction in fat deposition (fat loss: visceral > subcutaneous > liver). Further studies involving GHD patients with NAFLD are required to conclude the role of GHR in treating NAFLD.

Download Full-text