Horm Metab Res 2011; 43(13): 956-961
DOI: 10.1055/s-0031-1291246
Humans, Clinical
© Georg Thieme Verlag KG Stuttgart · New York

A Weekly Administered Sustained-release Growth Hormone Reduces Visceral Fat and Waist Circumference in Abdominal Obesity

J. W. Hong
1   Endocrinology, Yonsei University College of Medicine, Seoul, Korea
,
J. K. Park
1   Endocrinology, Yonsei University College of Medicine, Seoul, Korea
,
C.-Y Lim
2   Department of Medicine, Graduate School, Dongguk University, Seoul, Korea
,
S. W. Kim
3   Curensia Clinic, Seoul, Korea
,
Y.-S Chung
4   Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Gyeonggi, Korea
,
S. W. Kim
5   Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul Gyeonggi, Korea
,
E. J. Lee
1   Endocrinology, Yonsei University College of Medicine, Seoul, Korea
6   Endocrinology, Northwestern University Feinberg School of Medicine, Chicago, USA
› Author Affiliations
Further Information

Publication History

received 11 May 2011

accepted after second revision 21 September 2011

Publication Date:
09 November 2011 (online)

Abstract

Administration of recombinant human growth hormone (rhGH) in obesity has been known to lead to a decrease in visceral adiposity and an increase in lean body mass. Most studies have used supraphysiological doses of rhGH, which were administered daily or every other day. We aimed to evaluate whether weekly administered low dose of sustained-release rhGH (SR-rhGH) could play a therapeutic role in the treatment of abdominal obesity. Prospective, single-arm, open-label, multicenter pilot study was carried out. Participants were 26 adults aged 40–65 years old with abdominal obesity (male: waist circumference >90 cm, female: waist circumference >85 cm). The subjects were given 3 mg of SR-rhGH, administered subcutaneously, weekly for 26 weeks. SR-rhGH treatment for 26 weeks increased the IGF-1 level by 56.53±76.09 μg/l (SDS 0.77±1.12) compared to the baseline (p=0.0022). After 26 weeks, SR-rhGH treatment reduced abdominal visceral adipose tissue (VAT) (140.35±75.97 to 128.43±73.85 cm2, p=0.0038). Average waist circumference decreased from 96.25±6.41 to 91.93±6.13 cm (p<0.0001) after treatment. However, body weight or lean body mass did not show any significant change. In conclusion, SR-rhGH treatment for 26 weeks reduced abdominal visceral fat and waist circumference without severe adverse events. Further studies may be considered on the role of weekly administered SR-rhGH as a treatment for abdominal obesity.

 
  • References

  • 1 Bray GA. Medical consequences of obesity. J Clin Endocrinol Metab 2004; 89: 2583-2589
  • 2 Phillips LK, Prins JB. The link between abdominal obesity and the metabolic syndrome. Curr Hypertension Rep 2008; 10: 156-164
  • 3 Prez AP, Muoz JY, Corts VB, de Pablos Velasco P. Obesity and cardiovascular disease. Public Health Nutr 2007; 10: 1156-1163
  • 4 Grundy SM. Obesity, metabolic syndrome, and coronary atherosclerosis. Circulation 2002; 105: 2696-2698
  • 5 Despres JP, Lemieux I. Abdominal obesity and metabolic syndrome. Nature 2006; 444: 881-887
  • 6 Albert SG, Mooradian AD. Low-dose recombinant human growth hormone as adjuvant therapy to lifestyle modifications in the management of obesity. J Clin Endocrinol Metab 2004; 89: 695-701
  • 7 Franco C, Brandberg J, Lonn L, Andersson B, Bengtsson BA, Johannsson G. Growth hormone treatment reduces abdominal visceral fat in postmenopausal women with abdominal obesity: a 12-month placebo-controlled trial. J Clin Endocrinol Metab 2005; 90: 1466-1474
  • 8 Gotherstrom G, Bengtsson BA, Bosaeus I, Johannsson G, Svensson J. A 10-year, prospective study of the metabolic effects of growth hormone replacement in adults. J Clin Endocrinol Metab 2007; 92: 1442-1445
  • 9 Hoffman AR, Biller BM, Cook D, Baptista J, Silverman BL, Dao L, Attie KM, Fielder P, Maneatis T, Lippe B. Efficacy of a long-acting growth hormone (GH) preparation in patients with adult GH deficiency. J Clin Endocrinol Metab 2005; 90: 6431-6440
  • 10 Johannsson G, Marin P, Lonn L, Ottosson M, Stenlof K, Bjorntorp P, Sjostrom L, Bengtsson BA. Growth hormone treatment of abdominally obese men reduces abdominal fat mass, improves glucose and lipoprotein metabolism, and reduces diastolic blood pressure. J Clin Endocrinol Metab 1997; 82: 727-734
  • 11 Maison P, Griffin S, Nicoue-Beglah M, Haddad N, Balkau B, Chanson P. Impact of growth hormone (GH) treatment on cardiovascular risk factors in GH-deficient adults: a Metaanalysis of Blinded, Randomized, Placebo-Controlled Trials. J Clin Endocrinol Metab 2004; 89: 2192-2199
  • 12 Carroll PV, Christ ER, Snksen PH. Growth hormone replacement in adults with growth hormone deficiency: assessment of current knowledge. Trends Endocrinol Metab 2000; 11: 231-238
  • 13 Mekala KC, Tritos NA. Effects of recombinant human growth hormone therapy in obesity in adults: a meta analysis. J Clin Endocrinol Metab 2009; 94: 130-137
  • 14 Nam SY, Kim KR, Cha BS, Song YD, Lim SK, Lee HC, Huh KB. Low-dose growth hormone treatment combined with diet restriction decreases insulin resistance by reducing visceral fat and increasing muscle mass in obese type 2 diabetic patients. Int J Obes 2001; 25: 1101-1107
  • 15 Kim SJ, Hahn SK, Kim MJ, Kim DH, Lee YP. Development of a novel sustained release formulation of recombinant human growth hormone using sodium hyaluronate microparticles. J Controlled Release 2005; 104: 323-335
  • 16 Bidlingmaier M, Kim J, Savoy C, Kim MJ, Ebrecht N, de la Motte S, Strasburger CJ. Comparative pharmacokinetics and pharmacodynamics of a new sustained-release growth hormone (GH), LB03002, versus daily GH in adults with GH deficiency. J Clin Endocrinol Metab 2006; 91: 2926-2930
  • 17 Pasarica M, Zachwieja JJ, Dejonge L, Redman S, Smith SR. Effect of growth hormone on body composition and visceral adiposity in middle-aged men with visceral obesity. J Clin Endocrinol Metab 2007; 92: 4265-4270
  • 18 Ahn CW, Kim CS, Nam JH, Kim HJ, Nam JS, Park JS, Kang ES, Cha BS, Lim SK, Kim KR, Lee HC, Huh KB. Effects of growth hormone on insulin resistance and atherosclerotic risk factors in obese type 2 diabetic patients with poor glycaemic control. Clin Endocrinol (Oxf) 2006; 64: 444-449
  • 19 Jacobs EJ, Newton CC, Wang Y, Patel AV, McCullough ML, Campbell PT, Thun MJ, Gapstur SM. Waist Circumference and All-Cause Mortality in a Large US Cohort. Arch Intern Med 2010; 170: 1293-1301
  • 20 Utz AL, Yamamoto A, Sluss P, Breu J, Miller KK. Androgens may mediate a relative preservation of IGF-I levels in overweight and obese women despite reduced growth hormone secretion. J Clin Endocrinol Metab 2008; 93: 4033-4040
  • 21 Frystyk J, Brick DJ, Gerweck AV, Utz AL, Miller KK. Bioactive insulin-like growth factor-I in obesity. J Clin Endocrinol Metab 2009; 94: 3093-3097
  • 22 Juul A. Serum levels of insulin-like growth factor I and its binding proteins in health and disease. Growth Horm IGF Res 2003; 13: 113-170
  • 23 Carel JC, Butler G. Safety of Recombinant Human Growth Hormone. Endocr Dev 2010; 18: 40-54
  • 24 Halpern A, Mancini MC, Cercato C, Villares SM, Costa AP. Effects of growth hormone on anthropometric and metabolic parameters in android obesity. Arq Bras Endocrinol Metabol 2006; 50: 68-73
  • 25 Caidahl K, Edn S, Bengtsson BA. Cardiovascular and renal effects of growth hormone. Clin Endocrinol 1994; 40: 393-400
  • 26 Christ ER, Cummings MH, Westwood NB, Sawyer BM, Pearson TC, Snksen PH, Russell-Jones DL. The importance of growth hormone in the regulation of erythropoiesis, red cell mass, and plasma volume in adults with growth hormone deficiency. J Clinical Endocrinol Metab 1997; 82: 2985-2990
  • 27 Losa M, Scavini M, Gatti E, Rossini A, Madaschi S, Formenti I, Caumo A, Stidley CA, Lanzi R. Long-term effects of growth hormone replacement therapy on thyroid function in adults with growth hormone deficiency. Thyroid 2008; 18: 1249-1254
  • 28 Porretti S, Giavoli C, Ronchi C, Lombardi G, Zaccaria M, Valle D, Arosio M, Beck-Peccoz P. Recombinant human GH replacement therapy and thyroid function in a large group of adult GH-deficient patients: when does L-T(4) therapy become mandatory?. J Clinical Endocrinol Metab 2002; 87: 2042-2045
  • 29 Yuen KC, Dunger DB. Therapeutic aspects of growth hormone and insulin-like growth factor-I treatment on visceral fat and insulin sensitivity in adults. Diabetes Obes Metab 2007; 9: 11-22
  • 30 Bramnert M, Segerlantz M, Laurila E, Daugaard JR, Manhem P, Groop L. Growth hormone replacement therapy induces insulin resistance by activating the glucose-fatty acid cycle. J Clin Endocrinol Metab 2003; 88: 1455-1463
  • 31 Rizza RA, Mandarino LJ, Gerich JE. Effects of growth hormone on insulin action in man. Mechanisms of insulin resistance, impaired suppression of glucose production, and impaired stimulation of glucose utilization. Diabetes 1982; 31: 663-669
  • 32 Svensson J, Bengtsson BA. Safety aspects of GH replacement. Eur J Endocrinol 2009; 161 (Suppl. 01) S65-S74