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The effect of growth hormone replacement on serum lipids, lipoproteins, apolipoproteins and cholesterol precursors in adult growth hormone deficient patients
Author(s) -
RussellJones D. L.,
Watts G. F.,
Welssberger A.,
Naoumova R.,
Myers J.,
Thompson G. R.,
Sönksen P. H.
Publication year - 1994
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.1365-2265.1994.tb02555.x
Subject(s) - endocrinology , medicine , growth hormone , cholesterol , hormone , lipoprotein , chemistry , biology
Summary OBJECTIVE Adult patients with growth hormone deflciency are thought to be at higher risk of mortallty from cardiovascular disease. We therefore investlgated the effect of recombinant human growth hormone (rhGH) replacement therapy on fasting serum concentrations of IIplds, lipoproteins and cholesterol precursors in adult growth hormone deficient patients. DESIGN Double‐blind placebo controlled trial. Patients were randomly allocated to placebo or rhGH replacement therapy (0·018 Ulkglday for 1 month followed by 0·036 Ufkglday for 1 month). PATIENTS Eighteen patients with severe growth hormone deficiency. MEASUREMENTS Fasting lipid, lipoprotein and cholesterol precursors (lathosterol and mevalonic acid) were measured at baseline and after 2 months. RESULTS In the rhGH treated group there was a significant fall in serum cholesterol (P < 0·01) (6·44 ±0·49 to 5·71 ± 0·48 mmol/l), LDL cholesterol ( P < 0·02) (4·29 ± 0·49 to 3·62 ± 0·44 mmol/l), LDL cholesterollHDL cholesterol ratio ( P < 0·02) (3·99 · 0·62 to 3·26 ± 0·39), apollpo‐protein B (P>0·01 (1·30 ± 0·11 to 1·15 ± 0·11 g/l) and mevalonic acid ( P <0·05) (13·4 ±10·96 to 6·21 ± 1·91 μg/l). There were no significant changes In triglycerides, HDL cholesterol, apolipoprotein A1, lipoprotein (a) or lathosterol concentrations. In the GH treated group the rise in serum insulln was inversely correlated wlth the fall in cholesterol (P < 0·05), LDL cholesterol ( P < 0·01) and apolipoproteln B ( P < 0·01). There were no significant changes in any of the measured variables in the placebo group. CONCLUSION We conclude that GH may be involved in the regulation of lipid and lipoprotein metabolism and that rhGH replacement therapy of adult GHD patients is associated with beneficial changes in lipid and lipoprotein profiles. The reduction in mevalonic acid is consistent with up‐regulation of hepatic LDL receptors caused by GH and this may explain the fall in LDL cholesterol and apolipoprotein B concentrations.