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Growth Hormone (GH) Replacement Reduces Total Body Fat and Normalizes Insulin Sensitivity in GH-Deficient Adults: A Report of One-Year Clinical Experience¹

Section of Endocrinology and Metabolism (C.-M.H., C.F.K., T.-Y.L., L.-C.H., S.-H.L., L.-T.H.) and Section of Internal Medicine (C.-M.H.), Department of Medicine, and Department of Medical Research and Education (V.S.F., L.-T.H.), Veterans General Hospital-Taipei, Taipei, Taiwan 112; Department of Medicine (C.-M.H., C.F.K., L.-T.H.), National Yang-Ming University, Taipei, Taiwan 112; Section of Endocrinology and Metabolism (K.-C.S.), Department of Medicine, 804 General Hospital, Tao-Yuan, Taiwan 330; and Department of Medicine (T.-S.L.), Yuan-San Veterans Hospital, Yi-Lan, Taiwan 266 Republic of China

Address all correspondence and requests for reprints to: Low-Tone Ho, M.D., Department of Medical Research and Education, Veterans General Hospital-Taipei, Shih-Pai, Taipei, Taiwan 112, Republic of China.

The effects of GH replacement on body fat composition and insulin sensitivity were assessed in GH-deficient adults. The patients were randomized into a double-blind, placebo-controlled study of human recombinant GH replacement therapy for 6 months (period 1), followed by an open phase of GH for another 6 months (period 2). Anthropometric variables, body fat composition (fat %), and biochemical parameters were measured during the trial. Measurements of in vivo insulin sensitivity were carried out at the commencement of the study and on completion of the trial by modified insulin suppression test. The modified insulin suppression test was performed both in the morning (AM) and in the afternoon (PM) to further evaluate the PM-AM steady-state plasma glucose (SSPG) pattern. We found that the GH-deficient adults had more body fat and were insulin resistant. Significant reduction in fat % and total body fat mass was found in the active arm of period 1 without alteration of body weight. Besides, we demonstrated, for the first time, that GH replacement for 6 months did not alter the insulin sensitivity, but replacement for a longer period (12 months) normalized not only the AM SSPG level but also the PM-AM SSPG pattern. We also found a positive correlation between SSPG (regardless of AM vs. PM) and fat % and total body fat mass. In conclusion, normalization of insulin sensitivity in GH-deficient adults after replacement of GH may be related to the reduction of total body fat.

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