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Effects of recombinant human growth hormone therapy in adults with Prader–Willi syndrome: a meta‐analysis
Author(s) -
SanchezOrtiga Ruth,
Klibanski Anne,
Tritos Nicholas A.
Publication year - 2012
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.1365-2265.2011.04303.x
Subject(s) - medicine , endocrinology , body mass index , lean body mass , meta analysis , obesity , insulin resistance , body weight
Summary Objective Prader–Willi syndrome (PWS) is associated with GH deficiency, deleterious changes in body composition and function. As the effects of recombinant human GH (rhGH) in PWS adults have not been well established, we sought to conduct a meta‐analysis of pertinent studies. Design Meta‐analysis of studies examining the effects of rhGH therapy in PWS adults. Patients One hundred and thirty four PWS adults (75 men, 59 women). Measurements Literature searches, including publications (PubMed, EMBASE and the Cochrane Register), and abstracts presented at meetings through July 2011 describing studies of rhGH therapy in PWS adults; 8/1194 articles, describing unique cohorts, were included. Two authors independently extracted data and examined study quality. Results rhGH therapy for 12 months led to [weighted mean difference (95% CI)] decreased body fat [−2·91% (−3·90, −1·91)], visceral [−32·97 cm 2 (−55·67, −10·26)] and subcutaneous adiposity [−55·24 cm 2 (−89·05, −21·44)], and increased lean body mass (LBM) [2·41 Kg (1·32, 3·49)]. Similar changes in body fat [−2·89% (−4·69, −1·07)] and LBM [2·82 Kg (1·31, 4·33)] were found in longer studies. There were no changes in body mass index (BMI) or lipids. There was a small increase in fasting glucose [0·27 mmol/l (0·05, 0·49)] and trends towards higher fasting insulin [20·24 pmol/l (−0·55, 41·02)] and insulin resistance [HOMA: 0·60 (−0·04, 1·24)] after rhGH therapy for 12 months. Conclusions In PWS adults, rhGH therapy led to decreased body adiposity and increased LBM without changes in BMI or lipids. There was a small increase in fasting glucose and trends towards higher insulin and insulin resistance.