Circulating IGF-I levels in monitoring and predicting efficacy during long-term GH treatment of GH-deficient adults

Détails

ID Serval
serval:BIB_013AA365FE57
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Circulating IGF-I levels in monitoring and predicting efficacy during long-term GH treatment of GH-deficient adults
Périodique
European Journal of Endocrinology
Auteur(s)
Ezzat  S., Fear  S., Gaillard  R. C., Gayle  C., Marcovitz  S., Mattioni  T., Nussey  S., Rees  A., Svanberg  E.
ISSN
0804-4643 (Print)
Statut éditorial
Publié
Date de publication
12/2003
Volume
149
Numéro
6
Pages
499-509
Notes
Clinical Trial
Journal Article
Randomized Controlled Trial --- Old month value: Dec
Résumé
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.
Mots-clé
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
Création de la notice
15/02/2008 17:57
Dernière modification de la notice
03/03/2018 13:14
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