Effect of human growth hormone HGH and/or testosterone replacement on the prostate in HGH-deficient adult patients.
Colao A - J Clin Endocrinol Metab - 01-JAN-2003; 88(1): 88-94
From NIH/NLM MEDLINE
NLM Citation ID:
12519835 (PubMed)
Full Source Title:
Journal of Clinical Endocrinology and Metabolism
Publication Type:
Journal Article
Language:
English
Author Affiliation:
Department of Clinical and Molecular Endocrinology and Oncology, Federico II University of Naples, Italy. colao@unina.it
Authors:
Colao A; Di Somma C; Spiezia S; Filippella M; Pivonello R; Lombardi G
Abstract:
The prostate is a target organ of the HGH and IGF-I axis because prostate hypertrophy is found in acromegaly, reduced prostate size is found in HGH deficiency (HGHD) patients, and additionally, IGF-I is reported to be a positive predictor factor of prostate cancer. To investigate whether HGH replacement therapy in adult patients with HGHD has adverse effects on the prostate, we studied the effect of 12-month HGH or HGH plus testosterone replacement on prostate pathophysiology in 24 adult patients with GHD (11 euandrogenemic and 13 hypoandrogenemic), compared with 24 age-matched healthy controls. At study entry, GHD patients had lower prostate volume than controls (19.4 +/- 1.7 vs. 24.9 +/- 1.7 ml; P = 0.03). After 12 months of treatment, all hypoandrogenemic patients achieved normal testosterone levels, and prostate volume increased in the patients to the same level as controls (25.0 +/- 1.9 ml). The percentage increase in prostate volume was greater in hypoandrogenemic patients receiving both HGH and testosterone replacement (51 +/- 11%) than in those receiving HGH replacement alone (15 +/- 3%; P < 0.0009). At baseline, prostate volume was similar in HGHD patients below or above 60 yr of age (16.8 +/- 1.3 vs. 23 +/- 3.6 ml; P = 0.08), whereas after treatment it was higher in the latter patients (21.8 +/- 1.2 vs. 29.5 +/- 3.9 ml; P = 0.04). Prostate-specific antigen (PSA) and free PSA did not change, whereas PSA density was significantly reduced after treatment in hypoandrogenemic patients; there was also no change in calcifications, cysts, or nodules. In conclusion, GH replacement restores prostate size to normal in both young and elderly patients, with no increase in prostate abnormalities. Because the simultaneous treatment with HGH and testosterone induces an increase of prostate size by 50% of baseline on average, care is suggested in elderly patients with prostate hyperplasia to avoid any risk of prostate symptoms. In these cases, HGH replacement might be performed sequentially to reduce the hypertrophic effect of combining HGH and testosterone.
Major Subjects:
- Growth Hormone / adverse effects / * therapeutic use
- Human Growth Hormone / * deficiency
- Prostate / * drug effects / pathology / * physiopathology
- Testosterone / blood / * therapeutic use
Additional Subjects:
- Adult
- Aged
- Androgens / blood
- Drug Therapy, Combination
- Humans
- Longitudinal Studies
- Male
- Metabolism, Inborn Errors / blood / drug therapy / pathology
- Middle Aged
- Organ Size / drug effects
- Prostate-Specific Antigen / blood
Chemical Compound Name:
(Androgens); 12629-01-5(Human Growth Hormone); 58-22-0(Testosterone); 9002-72-6(Growth Hormone); EC 3.4.21.77(Prostate-Specific Antigen)