Exp Clin Endocrinol Diabetes 2006; 114 - P15_200
DOI: 10.1055/s-2006-933085

The effect of growth hormone replacement therapy on lipids, LDL- and HDL-subfractions in patients with growth hormone deficiency

T Minnemann 1, S Lescher 1, B Schamberger 1, M Torzewski 2, MM Weber 1, HC Geiss 1
  • 1Johannes-Gutenberg Universität zu Mainz, 1. Medizinische Klinik, Schwerpunkt Endokrinologie und Stoffwechsel, Mainz, Germany
  • 2Institut für klinische Chemie, Johannes-Gutenberg-Universität Mainz, Mainz, Germany

Patients with growth hormone deficiency show an unfavourable lipid profile which may be related to increased mortality. GH treatment is known to influence the lipid metabolism by enhancing lipolysis and LDL-receptor activity. Up to now there are no data how GH may influence LDL- and HDL-subfractions.

We included 5 male adults (53±11 ys., BMI 29.1±3.1kg/m2) with GH deficiency due to complete anterior hypopituitarism. Lipid concentrations, LDL- and HDL-subfractions were measured before (0) and 3 (+3) as well as 6 (+6) months during GH treatment. Seven LDL- (small-dense-LDL: LDL-5+LDL-6+LDL-7) and four HDL-subfractions (HDL-1–HDL-4) were isolated by density gradient ultracentrifugation and were quantified by measurement of cholesterol in each subfraction. All values shown are expressed as median, non-parametric tests (Wilcoxon-test, Friedman-test) were used.

GH therapy (median dose 0.2mg/d) increased plasma IGF-1 levels from 56 ng/ml to 181 ng/ml (+3) and then to 194 ng/ml (+6) (p<0.05). Cholesterol and LDL-cholesterol was not changed, while triglycerides (0: 141mg/dl, +3: 176mg/dl, +6: 160mg/dl, p<0.08) and VLDL-cholesterol increased (0: 28mg/dl, +3: 35mg/dl, +6: 32mg/dl, respectively). Concomitantly, HDL-subfractions showed a shift by an increase of HDL-3 (0: 24%, +3: 27%, +6: 26%, p<0.05) and a decrease of HDL-1 (22%, 14%, 12%, respectively, p<0.05). The LDL-subfraction profile shifted (p=0.08) to less dense LDL-subfractions after three months, but returned to baseline levels three months later (small-dense-LDL-chol. at 0: 47mg/dl (40%); +3: 43mg/dl (35%); +6: 52mg/dl (44%)).

In summary, slight changes in lipids and in the LDL- as well as HDL-subfraction profile were observed under GH therapy. These changes may be related to a rise in triglycerides caused by the lipolytic effect of GH. Interestingly, small dense LDL-cholesterol was temporarily decreased and did not exceed baseline levels three months later. Further studies with more patients are needed to test how a long term GH replacement therapy further affects these lipid parameters.