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Circulating IGF-I levels in monitoring and predicting efficacy during long-term GH treatment of GH-deficient adults.

Abstract：

OBJECTIVE:To investigate the effects of long-term GH in GH-deficient adults, as predicted by IGF-I levels. METHODS:Patients received GH, 5 microg/kg per day for 1 Month and 10 microg/kg per day for another 12-30 Months. Changes in body composition, cardiac structure/function, serum lipids and quality of life were measured. RESULTS:There was a significant increase in lean body mass (LBM) (2.21 kg; P<0.0001) after 6 Months, which was sustained throughout treatment. A larger increase occurred in males than females (2.97 vs 1.19 kg; P<0.0001). Total fat mass was reduced (2.56 kg; P<0.0001 (3.26 kg males, 1.63 kg females)). Responsiveness to GH varied greatly, but LBM changes correlated with IGF-I changes (P<0.004). Furthermore, thinner patients experienced greater and progressive LBM increases. There was an increase in ejection fraction (3.85+/-9.95%; P=0.0002) after 6 Months, sustained to 18 Months. These cardiac effects were equal for males and females, and did not correlate with IGF-I levels. Serum low-density lipoprotein/high-density lipoprotein ratios decreased within 6 Months, and were sustained thereafter. Quality of life improved significantly after 6 Months, an effect that was sustained/enhanced as treatment continued. No major adverse events were identified. CONCLUSIONS:Improved body composition is both reflected by IGF-I changes and predicted inversely by baseline adiposity. Other effects of GH replacement on cardiac function, dyslipidaemia and quality of life, however, do not correlate with circulating IGF-I concentrations. Our findings validate the importance of sustained GH therapy, but caution on the interpretation of IGF-I levels in monitoring the long-term effects of GH treatment.

journal_name

Eur J Endocrinol

journal_title

European journal of endocrinology

authors

Ezzat S,Fear S,Gaillard RC,Gayle C,Marcovitz S,Mattioni T,Nussey S,Rees A,Svanberg E

doi

10.1530/eje.0.1490499

subject

Has Abstract

pub_date

2003-12-01 00:00:00

pages

499-509

issue

eissn

0804-4643

issn

1479-683X

journal_volume

149

pub_type

临床试验,杂志文章,随机对照试验

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Circulating IGF-I levels in monitoring and predicting efficacy during long-term GH treatment of GH-deficient adults.