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Which adults develop side‐effects of growth hormone replacement?
Author(s) -
Holmes Sarah J.,
Shalet Stephen M.
Publication year - 1995
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.1365-2265.1995.tb01908.x
Subject(s) - medicine , placebo , growth hormone deficiency , endocrinology , body mass index , side effect (computer science) , hormone replacement therapy (female to male) , growth factor , growth hormone , hormone , testosterone (patch) , receptor , computer science , programming language , alternative medicine , pathology
Summary OBJECTIVE Although the nature of the side‐effects of G H replacement In adults are well described, the factors Influencing their development are III understood. The aim of this study was to determine whether there were any characteristics of adults with G H deficiency that predicted whether or not they developed side‐effects of G H replacement DESIGN A 12‐month study (double blind placebo controlled for the first 6 months and open for the second 6 months) of G H replacement (0.125 IU/kg/week for the first month and 0.25 IU/kg/week thereafter) In adults PATIENTS Sixty‐three adults (27 men, 36 women, aged 34.9 ±1.4 (mean ± SE, range 20.1‐59.5 years)) with G H deficiency (peak serum G H response to provocative testing of less than 10mU/l) who took part In a 12‐month study of G H replacement. Twenty‐five patients (40%) did not develop side‐effects, 19 patients (30%) developed side‐effects which did not necessitate a reduction In dose of G H, and 19 patients (30%) required a reduction In dose of G H because of side‐effects MEASUREMENTS The three groups of patients were compared according to age, height, weight and body mass index (BMI) at entry Into the study and to pretreatment peak serum G H response to provocative testing. They were also compared according to serum concentration of Insulin‐like growth factor (I G F)‐I and IGF binding proteln‐3, and age‐adjusted serum IGF‐I standard deviation score (SDS), at entry Into the study and by change In these measurements after 6 months of GH replacement. The patient's sex, whether GH deficiency was of childhood or adult onset, estimated duration of G H deficiency, presence or absence of additional pituitary hormone deficiencies, underlying pathological disorder and previous therapeutic Interventions were also compared In the three groups of patients RESULTS Those patients who required a reduction In dose of G H because of side‐effects were more likely to have a peak serum G H response of greater than 1 mU/l (P=0.005) and to have adult onset G H deficiency (P = 0‐04) than those who did not develop side‐effects or who did not require a reduction In dose of G H because of side‐effects. In addition, those who needed a reduction In G H dose were older (P = 0‐002), heavier (P = 0‐04) and had a greater BMI (P = 0‐003) than those who did not develop side‐effects. Those who developed side‐effects but did not require a reduction In dose of GH had a greater increment in I G F‐I S D S after 6 months of G H replacement than those who did not develop side‐effects (P‐0‐03). CONCLUSION Side‐effects of G H replacement are more likely to occur In older patients, In those with a peak serum G H response to provocative testing of greater then 1 mU/l, In those with a greater increment In serum I G F‐I S D S whilst receiving G H replacement, In those with greater weight and BMI, and those with adult onset G H deficiency