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Growth hormone dose regimens in adult GH deficiency: effects on biochemical growth markers and metabolic parameters
Author(s) -
Møller Jens,
Jørgensen Jens O. L.,
Lauersen Torben,
Frystyk Jan,
Næraa Rune W.,
Øsrskov Hans,
Christiansen Jens S.
Publication year - 1993
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.1993.tb02386.x
Subject(s) - medicine , endocrinology , respiratory exchange ratio , insulin like growth factor , growth hormone , insulin , growth factor , hormone , biology , receptor , heart rate , blood pressure
Summary OBJECTIVE We examined the effects of different doses of GH on insulin‐like growth factor I (IGF‐I), IGF binding protein 3 (IGFBP‐3), body composition, energy expenditure, and various metabolites in GH deficient adults, in order to approach a metabolically appropriate GH dosage in young GH deficient adults. DESIGN Ten GH deficient patients (age 21–43) were studied after 4 weeks without GH followed by three consecutive 4‐week periods, where the patients received in a fixed order GH 1,2 and 4 IU/m 2 s.c. per day. At the end of each period the patients were hospitalized for a 24‐hour examination. RESULTS Mean 24‐hour levels of GH (mIU/l) were 2.7±0.3 (0 GH), 7 2±0.9 (1), 10.8±1.5 (2) and 18.9±2.7 (4 IU/m 2 ) (mean ±SEM) ( P <0.01). Likewise, IGF‐I levels increased dose dependently from 61 ± 21 to 206 ± 65, 260 ± 70 and 468 ± 171 /μg/l ( P < 0 05); serum IGF‐I in an age and sex matched control group was 248 ± 25 /μg/l. Corresponding serum IGFBP‐3 levels also increased from 1860 ±239 to 3261 ±379, 3762 ±434 and 4384 ±652 /μg/l (P = 001) respectively. Significant increases in diurnal serum insulin levels after 4 IU/m 2 were recorded, whereas plasma glucose levels remained unchanged. Lipid intermediates increased dose independently during GH administration. GH caused a significant increase in resting energy expenditure, whereas the respiratory exchange ratio was unaltered. Fat mass was increased without GH therapy and decreased during the study. Four patients made complaints during 4 IU/m 2 GH administration, probably related to GH induced fluid retention. CONCLUSION Based primarily on IGF‐I and IGFBP‐3 levels our data suggest that a GH replacement dose in young GH deficient adults in the order of 1–2 IU/m 2 per day is adequate. This is a relatively low dose as compared to dose regimens in children and adolescents.