Effects of Growth Hormone Treatment beyond the Body Fat Changes in GH-deficient Adults

Kyung Wook Kim; Su Youn Nam; Dong Sun Kim; Chul Woo Ahn; Kyung Rae Kim; Sung-Kil Lim; EunJig Lee; Bong Soo Cha; Hyun Chul Lee; Jens M. Bruun; Bjørn Richelsen

Article

Korean J Obes 2013; 22(1): 56-65

Published online March 30, 2013

Effects of Growth Hormone Treatment beyond the Body Fat Changes in GH-deficient Adults

Kyung Wook Kim^*, Su Youn Nam⁽¹⁾, Dong Sun Kim^(2)*, Chul Woo Ahn⁽¹⁾, Kyung Rae Kim⁽¹⁾, Sung-Kil Lim⁽¹⁾, EunJig Lee⁽¹⁾, Bong Soo Cha⁽¹⁾, Hyun Chul Lee⁽¹⁾, Jens M. Bruun⁽³⁾, Bjørn Richelsen⁽³⁾

Author Affiliations

Vascular Metabolism Research Lab; Endocrinology and Metabolism Depart. Internal Medicine, Yonsei University, College of Medicine⁽¹⁾, Div. of Endocrinology and Metabolism, Depart. Internal Medicine, HanyangUniversity, College of Medicine⁽²⁾, Depart. Endocrinology and Metabolism MEA, Aarhus University Hospital, Denmark⁽³⁾

Received: October 2, 2012; Reviewed : October 30, 2012; Accepted: January 2, 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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Background: The mechanisms underlying the effects of growth hormone(GH) on fat metabolism in GH-deficient (GHD) patients are not fully understood. This study was to evaluate the effects of GH replacement before the body fat changes and their relevant parameters in GHD patients.
Methods: In total, 14 (5 males and 9 females) GHD adults (mean 34.4 ± 8.2 yr, BMI 23.1 ± 1.0 kg/m2) received
GH treatment for 12 weeks. Body composition by dual-energy X-ray absorptiometry and fasting serum analyses were assessed before and after treatment.
Results: GH replacement did not affect body weight (60.9 ± 3.0, vs. 60.3 ± 3.3 kg, P = 0.30), body fat mass (19.7 ± 1.5, vs. 18.4 ± 1.8 kg, P = 0.10) or HOMA IR (1.65 ± 0.3, vs. 1.94 ± 0.4, P = 0.34). However, serum adiponectin and
leptin levels were distinctly reduced after GH administration (6.86 ± 1.2, vs. 5.51 ± 0.8 mg/L, P = 0.03; 8.7 ± 1.1, vs. 6.5 ± 1.0 ng/mL, P < 0.01, respectively). Interestingly, correlations
between body fat mass and adipokines were stronger (adiponectin, before r = -0.502, P = 0.07 vs. after r = -0.634, P = 0.02; leptin, before r = 0.378, P = 0.18 vs. after r = 0.711, P = 0.004) after GH administration.
Conclusion: After 12 weeks-GH replacement, the reductions in serum adiponectin and leptin levels without significant body fat changes and the stronger correlations between body fat mass and these adipokines are reflective of the metabolic effects of GH probably due to the amelioration of compensatory mechanism of adiponectin like GHRH to overcome GH deficiency and leptin resistance in GHD patients.

Keywords: Growth hormone, Adiponectin, Leptin, Body fat

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Fig. 1. The levels of plasma adiponectin(A) and adiponectin per unit fat mass (B) before (□) and after (■) 12 weeks of GH treatment of GHD.

Fig. 2. The levels of plasma leptin (A) and leptin per unit fat mass (B) before (□) and after (■) 12 weeks of GH treatment of GHD.

Fig. 3. Correlations between total body fat (kg) and plasma adiponectin concentration before (A) and after (B) 12 weeks of GH treatment of GHD.

Fig. 4. Correlations between total body fat (kg) and plasma leptin concentration before (A) and after (B) 12 weeks of GH treatment of GHD.

Fig. 5. Correlations between HOMA IR and plasma adiponectin concentration before (A) and after (B) 12 weeks of GH treatment of GHD.

Fig. 6. Correlations between HOMA IR and plasma leptin concentration before (A) and after (B) 12 weeks of GH treatment of GHD.

Tables

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Clinical and biochemical characteristics of GHD patients before and after 12-week GH treatment

Biochemical characteristics of GHD female and male patients before and after 12-week GH treatment

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