Effect of growth hormone treatment on trunk fat accumulation in adult GH‐deficient Japanese patients:a randomised, placebo-controlled trial

Abstract

ABSTRACTObjective: Patients with growth hormone deficiency (GHD), both Japanese and Caucasian, have an abnormal body composition with pronounced abdominal obesity. This study aimed to evaluate changes in trunk fat with GH treatment.Design: Double-blind, placebo-controlled study.Patients and measurements: Sixty-one Japanese adult GH deficient patients (mean age 37 years) were randomised to either GH, titrated to 0.012 mg/kg/day, (n = 30) or placebo (n = 31) for 24 weeks. Body composition, by dual-energy X-ray absorptiometry (DXA), was evaluated at a central laboratory for trunk fat, total body fat and lean body mass. Serum lipid levels were also determined centrally.Results: At baseline, 26 (42.6%) patients had a body mass index (BMI) ≥ 25 kg/m2, the threshold for obesity-related complications for Japanese subjects. Median trunk fat mass (FM) was ≥ 9.0 kg for each treatment and gender group, higher than the cut-off for increased age-adjusted risk for cardiovascular complications reported in the normal Japanese population. After 24 weeks of GH treatment, the change in percentage trunk FM was –3.4 ± 0.6%, versus 0.4 ± 0.6% with placebo ( p < 0.001). Change in total body FM was –2.8 ± 0.5% with GH and 0.0 ± 0.5% with placebo, indicating that the decrease in trunk fat was more pronounced than for total body fat. Total and low density lipoprotein (LDL)-cholesterol were both significantly ( p < 0.001) decreased compared with placebo. One patient discontinued due to a subdural haematoma and one had GH dose reduced due to hyperglycaemia.Conclusions: Japanese patients with GHD have abnormal central fat accumulation, which is reduced by GH treatment over 24 weeks. This may reduce cardiovascular risk but the GH dose should be individualised to maintain IGF-I in the normal range.