Effects of GH in women with abdominal adiposity: a 6-month randomized, double-blind, placebo-controlled trial

被引:42
作者
Bredella, Miriam A. [1 ]
Lin, Eleanor [2 ]
Brick, Danielle J. [2 ]
Gerweck, Anu V. [2 ]
Harrington, Lindsey M. [2 ]
Torriani, Martin [1 ]
Thomas, Bijoy J. [1 ]
Schoenfeld, David A. [3 ]
Breggia, Anne [5 ]
Rosen, Clifford J. [5 ]
Hemphill, Linda C. [4 ,6 ]
Wu, Zida [7 ]
Rifai, Nader [8 ]
Utz, Andrea L. [9 ]
Miller, Karen K. [2 ]
机构
[1] Massachusetts Gen Hosp, Dept Radiol, Boston, MA 02114 USA
[2] Massachusetts Gen Hosp, Neuroendocrine Unit, Boston, MA 02114 USA
[3] Massachusetts Gen Hosp, Ctr Biostat, Boston, MA 02114 USA
[4] Harvard Univ, Sch Med, Boston, MA 02114 USA
[5] Maine Med Ctr Res Inst, Scarborough, ME 04074 USA
[6] Massachusetts Gen Hosp, Div Cardiol, Boston, MA 02114 USA
[7] Charite, Dept Med, D-10117 Berlin, Germany
[8] Childrens Hosp, Boston, MA 02115 USA
[9] Vanderbilt Univ, Nashville, TN 37232 USA
基金
美国国家卫生研究院;
关键词
GROWTH-HORMONE DEFICIENCY; CARDIOVASCULAR RISK-FACTORS; BODY-COMPOSITION; VISCERAL FAT; PREMENOPAUSAL WOMEN; REPLACEMENT THERAPY; INSULIN SENSITIVITY; RESONANCE SPECTROSCOPY; WAIST CIRCUMFERENCE; OBESE WOMEN;
D O I
10.1530/EJE-11-1068
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
Objective: Abdominal adiposity is associated with increased cardiovascular risk and decreased GH secretion. The objective of our study was to determine the effects of GH on body composition and cardiovascular risk markers in abdominally obese women. Materials and methods: In this randomized, double-blind, placebo-controlled study, 79 obese premenopausal women received GH vs placebo for 6 months. Primary endpoints were i) total abdominal (total abdominal adipose tissue, TAT) fat by computed tomography (CT) (body composition) and ii) high-sensitivity C-reactive protein (hsCRP) (cardiovascular risk marker). Body composition was assessed by CT, dual-energy X-ray absorptiometry, and proton MR spectroscopy. Serum cardiovascular risk markers, carotid intima-media thickness, and endothelial function were measured. Results: Mean 6-month GH dose was 1.7 +/- 0.1 mg/day, resulting in a mean IGF1 SDS increase from -1.7 +/- 0.08 to -0.1 +/- 0.3 in the GH group. GH administration decreased TAT and hsCRP compared with placebo. In addition, it increased thigh muscle mass and lean body mass and decreased subcutaneous abdominal and trunk fat, tissue plasminogen activator, apoB, and apoB/low-density lipoprotein compared with placebo. Visceral adipose tissue (VAT) decreased and intramyocellular lipid increased within the GH group. Six-month change in IGF1 levels was negatively associated with 6-month decrease in TAT and VAT. One subject had a 2 h glucose > 200 mg/ml at 3 months; four subjects, three of whom were randomized to GH, had 2 h glucose levels > 200 mg/ml at the end of the study. Conclusion: GH administration in abdominally obese premenopausal women exerts beneficial effects on body composition and cardiovascular risk markers but is associated with a decrease in glucose tolerance in a minority of women.
引用
收藏
页码:601 / 611
页数:11
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