Growth hormone-releasing hormone in HIV-infected men with lipodystrophy: a randomized controlled trial
| Autor: | Steven K. Grinspoon, Jeff Breu, Bridget Canavan, Polyxeni Koutkia, John Kissko, Martin Torriani |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty medicine.medical_treatment Population HIV Infections Placebo Growth Hormone-Releasing Hormone Double-Blind Method Internal medicine medicine Humans Insulin Insulin-Like Growth Factor I education Sermorelin education.field_of_study business.industry HIV-Associated Lipodystrophy Syndrome General Medicine Middle Aged medicine.disease Growth hormone–releasing hormone Lipids Tesamorelin Endocrinology Lean body mass Body Composition Lipodystrophy business medicine.drug |
| Zdroj: | JAMA. 292(2) |
| ISSN: | 1538-3598 |
| Popis: | ContextReduced growth hormone (GH) concentrations are observed in men with human immunodeficiency virus (HIV) lipodystrophy.ObjectiveTo investigate the effects of growth hormone–releasing hormone (GHRH), a GH secretagogue, in treatment of HIV lipodystrophy.Design, Setting, and ParticipantsRandomized, double-blind, placebo-controlled trial conducted at a research center in the United States between October 2002 and June 2003 and enrolling 31 HIV-infected men aged 18 to 60 years with evidence of lipodystrophy.InterventionsParticipants were assigned to receive GHRH (1 mg subcutaneously twice daily) or placebo for 12 weeks.Main Outcome MeasuresThe primary outcome was change in concentrations of insulin-like growth factor 1 (IGF-1) to detect overall change in GH levels in response to GHRH. Secondary end points included body composition by dual-energy x-ray absorptiometry and computed tomography, lipodystrophy ratings, and levels of glucose, insulin, and lipids.ResultsMean (SD) IGF-1 concentrations increased significantly in the GHRH group vs the placebo group (104 [110] ng/mL vs 6 [44] ng/mL, P = .004). Lean body mass significantly increased in the GHRH group vs the placebo group (0.9 [1.3] kg vs −0.3 [1.7] kg, P = .04), trunk fat significantly decreased (−0.4 [0.7] kg vs 0.2 [0.6] kg, P = .03), and the ratio of trunk to lower extremity fat improved significantly (−0.22 [0.32] vs 0.14 [0.29], P = .005). Abdominal visceral fat was reduced (–19.2 [36.6] cm2 vs 2.3 [24.3] cm2, P = .07) and the ratio of abdominal visceral fat to abdominal subcutaneous fat improved significantly more in the GHRH group (–0.19 [0.28] vs 0.07 [0.27], P = .02). Both physician and patient rating of lipodystrophy in the arms, legs, and abdomen also improved significantly. Levels of glucose, insulin, and lipids did not change significantly.ConclusionsGHRH was well tolerated and effectively increased levels of IGF-1 in HIV-infected men with lipodystrophy. Total and regional body composition improved in response to GHRH, with increased lean mass and reduced truncal and visceral fat. Use of GHRH may potentially be a beneficial treatment strategy for this population. |
| Databáze: | OpenAIRE |
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