Impact of human growth hormone HGH treatment on cardiovascular risk factors in HGH-deficient adults: a Metaanalysis of Blinded, Randomized, Placebo-Controlled Trials.
Maison P - J Clin Endocrinol Metab - 01-MAY-2004; 89(5): 2192-9
From NIH/NLM MEDLINE
NLM Citation ID:
15126541 (PubMed)
Full Source Title:
Journal of Clinical Endocrinology and Metabolism
Publication Type:
Journal Article; Meta-Analysis
Language:
English
Author Affiliation:
Clinical Pharmacology, Clinical Research Unit, Assistance Pubique-Hôpitaux de Paris, Henri Mondor University Hospital, F-94010 Créteil, France.
Authors:
Maison P; Griffin S; Nicoue-Beglah M; Haddad N; Balkau B; Chanson P
Metaanalysis of Blinded, Randomized, Placebo-Controlled Trials
Abstract:
Patients with hypopituitarism have an increased risk of cardiovascular mortality. HGH treatment could modify the cardiovascular risk in adults with GH deficiency, but most published clinical trials involved few patients and the results are variable. We conducted a systematic review of blinded, randomized, placebo-controlled trials of HGH treatment in adult patients with HGH deficiency published up to August 2003. Thirty-seven trials were identified. We combined the results for effects on lean and fat body mass; body mass index; triglyceride and cholesterol [high-density lipoprotein, low-density lipoprotein (LDL), and total] levels; blood pressure; glycemia; and insulinemia. Overall effect size was used to evaluate significance, and weighted differences between HGH and placebo were used to appreciate the size of the effect. GH treatment significantly reduced LDL cholesterol [-0.5 (SD 0.3) mmol/liter], total cholesterol [-0.3 (0.3) mmol/liter], fat mass [-3.1 (3.3) kg], and diastolic blood pressure [-1.8 (3.8) mm Hg] and significantly increased lean body mass [+2.7 (2.6) kg], fasting plasma glucose [+0.2 (0.1) mmol/liter], and insulin [+8.7 (7.0) pmol/liter]. All effect sizes remained significant in trials with low doses and long-duration GH treatment. Thus, HGH treatment has beneficial effects on lean and fat body mass, total and LDL cholesterol levels, and diastolic blood pressure but reduces insulin sensitivity. The global cardiovascular benefit remains to be determined in large trials with appropriate clinical endpoints.
Major Subjects:
- Cardiovascular Diseases / * etiology
- Human Growth Hormone / * therapeutic use
- Human Growth Hormone / * deficiency
Additional Subjects:
- Adult
- Aged
- Blood Glucose / analysis
- Blood Pressure
- Body Composition
- Dose-Response Relationship, Drug
- Double-Blind Method
- Drug Administration Schedule
- Female
- Humans
- Insulin / blood
- Lipids / blood
- Male
- Metabolism, Inborn Errors / complications / drug therapy / physiopathology
- Middle Aged
- Placebos
- Randomized Controlled Trials
- Risk Factors
Chemical Compound Name:
(Blood Glucose); (Lipids); (Placebos); 11061-68-0(Insulin); 12629-01-5(Human Growth Hormone); 9002-72-6(Human Growth Hormone)