Interactions of Body Fat and Muscle Mass with Substrate Concentrations and Fasting Insulin Levels in Adults with Growth Hormone Deficiency

1994 ◽  
Vol 87 (2) ◽  
pp. 201-206 ◽  
Author(s):  
F. Salomon ◽  
R. C. Cuneo ◽  
A. M. Umpleby ◽  
P. H. Sönksen
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Lean Body Mass ◽  
Body Mass ◽  
Fat Mass ◽  
Insulin Level ◽  
Hormone Deficiency ◽  
Fasting Plasma ◽  
Fasting Plasma Insulin ◽  
Substrate Concentrations

1. Adults with growth hormone deficiency have an abnormal body composition. Alterations in body composition are closely related to substrate concentrations and insulin action. The lack of growth hormone has been associated with increased insulin sensitivity. 2. We investigated the correlations of body composition with fasting insulin levels and substrate concentrations in 24 adults with growth hormone deficiency over a wide range of adiposity (body mass index 18.8-42.3 kg/m2). 3. Lean body mass was measured by total body potassium, computer tomography of the thigh and urinary creatinine excretion. Muscle fibre distribution was evaluated from vastus lateralis biopsies. Fat mass was assessed by skinfold thickness measurements, computer tomography of the thigh, and waist and hip girth. 4. Fasting plasma insulin level increased with fat mass (r = 0.67, P = 0.0004) and with waist girth (r = 0.76, P = 0.0001). Fasting plasma insulin level increased with fasting plasma glucose level (r = 0.53, P = 0.01). Fasting plasma glucose level in turn was positively correlated with lean body mass (r = 0.49, P = 0.01) and with total thigh muscle area (r = 0.54, P = 0.01). There was no correlation between lean body mass and fat mass (r = 0.17, not significant) nor between muscle fibre types and fat mass or fat distribution. Fasting plasma insulin level showed no correlation with any measurement of lean body mass or muscle fibre type. 5. These data demonstrate that the presence of obesity is associated with hyperinsulinaemia as the result of insulin resistance in adults with growth hormone deficiency, which could contribute to the increased cardiovascular mortality in adults with growth hormone deficiency.

Basal metabolic rate in adults with growth hormone deficiency and in patients with acromegaly: relationship with lean body mass, plasma insulin level and leucocyte sodium pump activity

1992 ◽  
Vol 83 (3) ◽  
pp. 325-330 ◽  
Author(s):  
Franco Salomon ◽  
Ross C. Cuneo ◽  
Richard Hesp ◽  
Jenny F. Morris ◽  
Lucilla Poston ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Metabolic Rate ◽  
Growth Hormone Deficiency ◽  
Lean Body Mass ◽  
Body Mass ◽  
Basal Metabolic Rate ◽  
Plasma Insulin ◽  
Recombinant Human Growth Hormone ◽  
Hormone Deficiency ◽  
Sodium Efflux

1. The relationship of lean body mass, plasma insulin concentration and leucocyte active sodium transport with basal metabolic rate was investigated in 24 adults with growth hormone deficiency before and after treatment with recombinant human growth hormone and in 10 patients with untreated acromegaly. 2. Based on total-body potassium determined by whole-body 40K counting, patients with acromegaly had increased lean body mass, whereas lack of growth hormone was associated with decreased lean body mass. 3. By indirect calorimetry, patients with acromegaly had increased basal metabolic rates and patients with growth hormone deficiency had decreased values when expressed as percentages of values predicted from the WHO/FAO/UNU equations. Basal metabolic rate expressed in terms of lean body mass was similar in acromegaly and growth hormone deficiency, but was higher than normal in both patient groups. 4. The leucocyte ouabain-sensitive sodium efflux rate constant was decreased in both patients with acromegaly and patients with growth hormone deficiency, and there was no correlation with basal energy expenditure, fasting plasma insulin level or serum growth hormone level. 5. There was no increase in the sodium efflux rate constant in patients with growth hormone deficiency after 1 month on treatment with recombinant human growth hormone. 6. Apparent differences in basal metabolic rate in growth hormone deficiency and acromegaly are due to changes in lean body mass. Both adults with growth hormone deficiency and patients with acromegaly have increased energy expenditure, probably owing to changes in fuel metabolism which are not reflected in the leucocyte sodium pump activity.

Increased body fat mass and decreased extracellular fluid volume in adults with growth hormone deficiency

1993 ◽  
Vol 38 (1) ◽  
pp. 63-71 ◽  
Author(s):  
Thord Rosen ◽  
Ingvar Bosaeus ◽  
Jukka TöIli ◽  
Göran Lindstedt ◽  
Bengt-Åke Bengtsson
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Body Fat ◽  
Fat Mass ◽  
Extracellular Fluid ◽  
Fluid Volume ◽  
Extracellular Fluid Volume ◽  
Hormone Deficiency ◽  
Body Fat Mass

Body composition and metabolic health of young male adults with childhood-onset multiple pituitary hormone deficiency after cessation of growth hormone treatment

2018 ◽  
Vol 31 (5) ◽  
pp. 533-537 ◽  
Author(s):  
Hongbo Yang ◽  
Linjie Wang ◽  
Xiaonan Qiu ◽  
Kemin Yan ◽  
Fengying Gong ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Body Composition ◽  
Growth Hormone Deficiency ◽  
Fat Mass ◽  
Hormone Deficiency ◽  
Pituitary Hormone ◽  
Childhood Onset ◽  
Multiple Pituitary Hormone Deficiency ◽  
Pituitary Hormone Deficiency ◽  
Male Patients

Abstract Background: Recombinant human growth hormone (rhGH) replacement therapy is usually stopped after linear growth completion in patients with growth hormone deficiency. In patients with multiple pituitary hormone deficiency (MPHD), the long-term effects of discontinuation of rhGH replacement are unknown. Methods: In this study, the anthropometric and metabolic parameters of 24 male patients with adult growth hormone deficiency (AGHD) due to MPHD in childhood after cessation of rhGH therapy for a mean of 7.1 years were measured and compared with 35 age-matched controls. Body composition was evaluated by bioelectrical impedance analysis (BIA). Results: In the AGHD group, body mass index (BMI) was significantly increased and 29.2% had obesity. The AGHD group had a 17.7 cm increase in waist circumference (WC). The fat free mass (FFM) was significantly lower in the AGHD group. Both the fat mass (FM) and percentage of fat mass (FM%) were significantly increased in the AGHD group. Both the systolic blood pressure (BP) and diastolic pressure were significantly lower in AGHD group. The lipid profile was generally similar in both groups, except for a decrease of high density lipoprotein-cholesterol (HDL-C) in the AGHD group. There was significant hyperuricemia in the AGHD group. Conclusions: Cessation of rhGH leads to a significant increase of FM in early adulthood in male patients with childhood-onset MPHD (CO-MPHD).

scholarly journals SUN-310 Growth Hormone Deficiency and Replacement Therapy: Association with Health-Related Physical Fitness

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Adriana Claudia Lopes Carvalho-Furtado ◽  
Cintia Ramari ◽  
Edgard Soares ◽  
Daniel R F Saint-Martin ◽  
Luiz Guilhemme Grossi Porto ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Body Composition ◽  
Growth Hormone Deficiency ◽  
Replacement Therapy ◽  
Body Mass ◽  
Handgrip Strength ◽  
Hormone Deficiency ◽  
Walk Test ◽  
Six Minute Walk Test ◽  
Minute Walk

Abstract Objective: To compare health-related physical fitness (HRPF) in patients with severe adult growth hormone deficiency (AGHD) according to the deficiency onset phase, and to evaluate the effects of a six-months human growth hormone (rhGH) replacement therapy on HRPF, in a subgroup of patients. Methods: First arm: cross-sectional observational study at baseline of naive rhGH multiple pituitary hormonal deficiency (MPHD) hypopituitarism patients - adult-onset growth hormone deficiency (AO-GHD) versus child onset growth hormone deficiency (CO-GHD). Second arm: a 6-month intervention clinical trial in a selected group of a non-randomized, non-controlled cohort. HRPF was evaluated by measuring isokinetic and isometric torque stensor strength at the knee using an isokinetic dynamometer, handgrip strength and six-minute walk test. Body composition was assessed by DXA. Results: Patients who presented AO-GHD had higher BMI than CO-GHD (28.1±3.5 x 22.4±4.8; p=0.017), but body composition (lean body mass%:57.9±7.9 x 58.9±8.6;p=0.816/fatty body mass%:39.3±6.8 x 36.0±9.1;p=0.434), stensor peak torque/body weight at 60, 90 and 180deg/s (2.18±0.6 x 2.18±0.6; p=0.580/1.99±0.5 x 2.14±0.5;p=0.546/1.52±0.4 x 1.64±0.4;p=0.547), isometric torque/body weight at the knee (2.62±0.7 x 2.91±0.6;p=0.357) and six-minute walk test (570.2±76.0cm x 554.1±91.0cm;p= 0.703) did not differ between groups. Handgrip strength test also showed significant reduction in scores for age and gender in both groups of GHD patients. After six months of rhGH, no improvement in muscular strength tests was found. There was a significant worsening in the six-minute walk test (575.1±84cm x 545.4±90.6cm; p=0.033) despite the improvement in body composition (lean body mass%:59.7±8.6 x 63.6±11.1;p=0.005/fatty body mass%:35.7±9.2 x 32.9±10.0;p=0.003). Conclusion: Despite differences in BMI, there were no other differences in HRPF between AO-GHD and CO-GHD patients. The decrease of the six-minute walking test performance after rhGH replacement therapy supports the clinical evidence that the GH regulates bioenergetics in human skeletal muscle fibers. Although the treatment had a short period, GH might have stimulated the anaerobic and suppressed the aerobic energy system.

scholarly journals Circulating LEAP-2 Levels in Adult Growth Hormone Deficiency and Their Relationship With IGF-1

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A534-A534
Author(s):  
Edoardo Vergani ◽  
Carmine Bruno ◽  
Cesare Gavotti ◽  
Emmanuel Capobianco ◽  
Diego Currò ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Weight Gain ◽  
Growth Hormone Deficiency ◽  
Fat Mass ◽  
Inverse Correlation ◽  
Hormone Deficiency ◽  
Growth Hormone Secretagogue ◽  
Adult Growth Hormone Deficiency ◽  
Adult Growth ◽  
Group A

Abstract Liver enriched antimicrobial peptide-2 (LEAP-2) is an endogenous antagonist of ghrelin, which acts as an allosteric modulator of growth hormone secretagogue receptors. It is expressed predominantly in liver, followed by kidney, jejunum, duodenum and stomach. Its expression in conditions of metabolic impairment, obesity for instance, may be upregulated, usually pairing with a concomitant reduction in ghrelin secretion. Weight gain and hyperglycaemia seem to be the main trigger factors for LEAP-2 production. Adult growth hormone deficiency (aGHD) is known as a pathological condition characterized by metabolic impairment (insulin resistance, weight gain, increased fat mass, decreased lean mass). To the best of our knowledge, no study in literature deals with the problem of circulating LEAP-2 levels in GHD. Therefore, the primary endpoint of this cross-sectional observational study was to evaluate circulating LEAP-2 levels in GHD in comparison to healthy controls whether the secondary endpoint was to evaluate any possible correlation with IGF-1 and metabolic parameters in such condition. 30 patients were included in the study. Group A included adult GHD: 15 patients, 7 females and 8 males, mean±standard error of the mean (SEM) age 54.6±3.51 years, BMI 29,95±1.63 kg/m2). The etiologies of GHD were empty sella (n=6), idiopathic (n=6), post-surgical hypopituitarism (n=2), pineal cyst (n=1). Group B was formed by controls: 15 patients, 11 females and 4 males, mean±SEM age 40.33±2.61 years, BMI 24.19±1.33 kg/m2. They were evaluated for: serum glucose and insulin, HOMA-index, QUICKI-index, Total/LDL/HDL cholesterol, triglycerides, IGF-1 and LEAP-2 (measured using Human LEAP-2 ELISA kit, Phoenix Pharmaceuticals Inc, according to manufacturer’s instructions). Circulating LEAP-2 is significantly higher in GHD than in control group (26.98±3.12 vs 18.7±1.9 ng/ml, p=0.03). LEAP-2 levels in our cohort was not influenced by BMI, while a significant direct correlation between LEAP-2 and age was detected in aGHD group. A strong significative inverse correlation between LEAP-2 and IGF-1 was evidenced in aGHD (r2=0.5). Finally, in this group, LEAP-2 inversely correlates with total cholesterol (r2=0.45). As expected circulating LEAP-2 levels, in a condition of metabolic impairment such as GHD, were higher than controls even if no correlation with BMI was evidenced in our cohort. The inverse correlation between LEAP-2 and IGF-1 in GHD patients may suggest a body adjustment in a worse clinical condition. LEAP-2 may act as a brake for ghrelin production, thus preventing further weight gain and fat mass increase, although losing its secretagogue effect.

scholarly journals Relationship between IGF-I Concentration and Metabolic Profile in Children with Growth Hormone Deficiency: The Influence of Children’s Nutritional State as well as the Ghrelin, Leptin, Adiponectin, and Resistin Serum Concentrations

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Renata Stawerska ◽  
Joanna Smyczyńska ◽  
Maciej Hilczer ◽  
Andrzej Lewiński
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Body Mass ◽  
Metabolic Profile ◽  
Hormone Deficiency ◽  
Molar Ratio ◽  
Healthy Children ◽  
Serum Concentrations ◽  
Igf I ◽  
Igfbp 3

Background. Some, however not all, children with growth hormone deficiency (GHD) reveal a tendency towards metabolic disorders. Insulin-like growth factor I (IGF-I) is the main mediator of GH anabolic effects. Objective. The aim of the study was to compare ghrelin, adiponectin, leptin, resistin, lipid, glucose, and insulin concentrations in GHD children, depending on the IGF-I bioavailability. Methods. The analysis comprised 26 children with GHD, aged 5.7–15.3 yrs. Fasting serum concentrations of IGF-I, IGFBP-3, ghrelin, leptin, adiponectin, resistin, lipids, glucose, and insulin were measured. The GHD children were divided into two subgroups: (1) with lower IGF-I/IGFBP-3 molar ratio and (2) with higher IGF-I/IGFBP-3 molar ratio. The control group consisted of 39 healthy children, aged 5.1–16.6 yrs, of normal height and body mass. Results. GHD children with lower IGF-I/IGFBP-3 molar ratio were found to have a significantly lower body mass and insulin and triglyceride concentrations, as well as significantly higher ghrelin and adiponectin concentrations than GHD children with higher IGF-I/IGFBP-3. Conclusions. A better metabolic profile characterised GHD children with low IGF-I bioavailability. This phenomenon may be the result of high adiponectin and ghrelin concentrations in those children and their influence on adipose tissue, glucose uptake, and orexigenic axis.

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