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Silvia Savastano, Carolina Di Somma, Luigi Angrisani, Francesco Orio,
Salvatore Longobardi, Gaetano Lombardi, and Annamaria Colao
J. Clin.
Endocrinol. Metab. 94: 817-826; published online before print as
doi:10.1210/jc.2008-1476
The purpose of this open, prospective,
randomized, and controlled study was to investigate if growth hormone (GH)
treatment prevents lean body mass (LBM) loss in the early postoperative period
after bariatric surgery. Patients are at risk of losing needed lean body mass
and skeletal muscle mass after bariatric surgery due to the serious
complications associated with rapid and sustained weight loss. The loss of lean
body mass negatively influences the outcome of the surgery. Impaired GH
secretion is frequent in obese patients.
The six month study included 24
women who underwent laparoscopic-adjustable silicone gastric banding surgery and
were diagnosed with growth hormone deficiency after the procedure. The
participants were randomized into two groups. Both groups participated in a
standardized diet and exercise program, and one group also received recombinant
human growth hormone (approximately 0.5 mg/ day).
Weight loss did not
differ between groups after 3 and 6 months. At 3 months, LBM loss was lower and
fat mass (FM) loss was higher in group receiving GH treatment. At 3 and 6
months, appendicular skeletal muscle mass loss was lower and percent changes of
FM and lean body mass were significantly higher in the GH treated women. In both
groups fasting glucose insulin levels were significantly reduced. Insulin
sensitivity indexes and total to high-density lipoprotein cholesterol ratio
improved only in the group receiving GH treatment.
The study concluded
that growth hormone treatment for 6 months after laparoscopic-adjustable
silicone gastric banding surgery reduces loss in lean body mass and appendicular
skeletal muscle mass during a standardized program of low-calorie diet and
physical exercise program, with improvement of lipid profile and without a
deterioration of glucose tolerance.
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