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Mekala KC, Tritos NA
Division of Internal Medicine, Lahey Clinic Medical
Center, Burlington, Massachusetts
J Clin Endocrinol Metab. 2009 Jan;
94(1):130-7
The purpose of this meta-analysis was to examine the
efficacy and safety of recombinant human GH (rhGH) as therapy for obesity in
adults. The reviewers conducted a thorough search of the literature (including
MEDLINE, EMBASE, and the Cochrane Register) for pertinent studies, which were
analyzed and subsequently synthesized.
Administration of rhGH led to
significant improvements in body composition, including fat mass, percent body
fat, lean body mass, visceral adipose area, and lipid profile (including total
cholesterol and low-density lipoprotein-cholesterol). There were increases in
fasting plasma glucose and insulin found only in shorter-term studies. Adverse
effects included joint pain, peripheral edema, and paresthesias (a burning,
itching or tingling skin sensation).
This meta-analysis suggests that
rhGH therapy leads to decrease in visceral adiposity and increase in lean body
mass as well as beneficial changes in lipid profile in obese adults, without
inducing weight loss. Administration of rhGH was associated with increases in
fasting plasma glucose and insulinemia. Because the rhGH doses used in many
studies were supraphysiological, future studies of longer duration, using
carefully titrated rhGH protocols, will be needed to fully establish the effects
of rhGH therapy in obesity, including effects on cardiovascular morbidity and
mortality.
