Low-dose GH replacement improves the adverse lipid profile associated with the adult GH deficiency syndrome

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Murray RD, Wieringa GE, Lissett CA, Darzy KH, Smethurst LE, Shalet SM

Clin Endocrinol (Oxf). 2002 Apr; 56(4):525-32.

The purpose of this study was to determine if low dose GH therapy could improve the serum lipid profile of persons with adult growth hormone deficiency (AGHD). AGHD is characterized by increased fat mass, reduced muscle mass, adverse lipid profiles, low bone density, increased cardiovascular risk and impaired quality of life. The lipid profiles of those with AGHD include elevated total cholesterol (TC), low-density lipoprotein cholesterol (LDLC) and triglyceride level (TG) along with reduced high-density lipoprotein cholesterol (HDLC) and a higher TC/HDLC ratio (a marker of cardiovascular risk).

This 2 year study included 67 adult participants (average age 37) who had been diagnosed with growth hormone deficiency. 35 of the participants had been diagnosed during childhood; the balance had acquired a GH deficiency as adults. 37 of the participants were female, and 16 of those were also undergoing estrogen replacement therapy during the study. 44 of the participants were being treated for hypopituitarism and continued their medication during the study period.

Initial testing was done to establish baseline measurements and participants were taught to self-administer subcutaneous GH injections. GH doses were adjusted every 4-6 weeks as necessary to normalize IGF-1 levels. Serum lipid levels were tested at baseline, 12 months and 24 months.

Reductions in TC were observed at both 12 and 24 months. LDLC levels did not show significant improvement until 24 months. HDLC levels did not change but there was significant improvement in the TC/HDLC ratio at both 12 and 24 months. A significant decrease in TG was seen at 12 months and maintained at 24 months. The greatest improvements in lipid levels occurred in those participants that had the most adverse lipid profiles at baseline, which included the females and those with AGHD or MPHD (multiple pituitary hormonal deficiency). Participants that achieved the greatest changes in body composition also showed the most improvement in serum lipid levels.

The researchers concluded that low dose GH replacement aimed at normalizing IGF-1 is associated with significant improvements in TC, LDLC, TGs and TC/HDLC ratio. Improvements in serum lipids are independent of changes in IGF-1 levels or GH dose.

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