Circulating IGF-I levels in monitoring and predicting efficacy during long-term GH treatment of GH-deficient adults
Details
Serval ID
serval:BIB_013AA365FE57
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Circulating IGF-I levels in monitoring and predicting efficacy during long-term GH treatment of GH-deficient adults
Journal
European Journal of Endocrinology
ISSN
0804-4643 (Print)
Publication state
Published
Issued date
12/2003
Volume
149
Number
6
Pages
499-509
Notes
Clinical Trial
Journal Article
Randomized Controlled Trial --- Old month value: Dec
Journal Article
Randomized Controlled Trial --- Old month value: Dec
Abstract
OBJECTIVE: To investigate the effects of long-term GH in GH-deficient adults, as predicted by IGF-I levels. METHODS: Patients received GH, 5 microg/kg per day for 1 Month and 10 microg/kg per day for another 12-30 Months. Changes in body composition, cardiac structure/function, serum lipids and quality of life were measured. RESULTS: There was a significant increase in lean body mass (LBM) (2.21 kg; P<0.0001) after 6 Months, which was sustained throughout treatment. A larger increase occurred in males than females (2.97 vs 1.19 kg; P<0.0001). Total fat mass was reduced (2.56 kg; P<0.0001 (3.26 kg males, 1.63 kg females)). Responsiveness to GH varied greatly, but LBM changes correlated with IGF-I changes (P<0.004). Furthermore, thinner patients experienced greater and progressive LBM increases. There was an increase in ejection fraction (3.85+/-9.95%; P=0.0002) after 6 Months, sustained to 18 Months. These cardiac effects were equal for males and females, and did not correlate with IGF-I levels. Serum low-density lipoprotein/high-density lipoprotein ratios decreased within 6 Months, and were sustained thereafter. Quality of life improved significantly after 6 Months, an effect that was sustained/enhanced as treatment continued. No major adverse events were identified. CONCLUSIONS: Improved body composition is both reflected by IGF-I changes and predicted inversely by baseline adiposity. Other effects of GH replacement on cardiac function, dyslipidaemia and quality of life, however, do not correlate with circulating IGF-I concentrations. Our findings validate the importance of sustained GH therapy, but caution on the interpretation of IGF-I levels in monitoring the long-term effects of GH treatment.
Keywords
Adipose Tissue/metabolism
Adult
Aged
Biological Markers/*blood
Body Composition/*drug effects
Body Mass Index
Bone Density/drug effects
Bone and Bones/drug effects
Dose-Response Relationship, Drug
Female
Growth Disorders/drug therapy/psychology
Health Status Indicators
Heart/drug effects
*Hormone Replacement Therapy
Human Growth Hormone/*deficiency/*therapeutic use
Humans
Insulin-Like Growth Factor I/*metabolism
Lipids/blood
Long-Term Care
Male
Middle Aged
Quality of Life
Treatment Outcome
Pubmed
Web of science
Create date
15/02/2008 17:57
Last modification date
20/08/2019 13:23