Results of treatment with human recombinant growth hormone in patients with multiple pituitary hormone deficiency

Abstract

This open study was undertaken to evaluate the effect of small-dose recombinant human growth hormone (GH) Biosoma replacement therapy in adult patients with multiple pituitary hormone deficiencies on anthropometric parameters, body composition, metabolism, and blood levels of hormones. The study included 18 adult patients (9 females and 9 males) aged 21 to 40 years, in whom hypopituitarism was diagnosed in childhood. Before the study, growth hormone deficiency was again confirmed in all the patients, by using the insulin test and determining the levels of insulin-like growth factor 1 (IGF-1). All the patients received Biosoma (Biopha, Lithuania) in a subcutaneous dose of 2 international units (IV) 6 times a week for 12 months. Examinations were made before and 6 and 12 months during therapy. The examinations estimated the following anthropometric parameters: height, body mass, body mass index (BMI), waist-hip circumference ratio (WHCR), bone age, composition: waist-hip circumference ratio, body composition (lean, fatty, and water body mass), metabolism, the level of growth hormone (GH), IGF-1, triiodothyronine (T3), free thyroxine (Т4) thyroid-stimulating hormone (TSH), cortisol, luteinizing hormone and follicle-stimulating hormones, testosterone, estradiol (E2) and progesterone. During treatment, there were statistically increases in BMI, body mass, and metabolism, a decrease in WHCR, a change in body composition (lean and water body mass increased statistically significantly and fatty mass did not change significantly). The blood levels of GH, TSH, gonadotropins, sex hormones, and cortisol showed no significant change during therapy. Throughout treatment, the blood level of IGF-1 and T3 significantly increased. A significant positive correlation was established between the elevated blood levels of IGF-1 and T3 during GH treatment. The changes occurring in thyroid regulation may be accounted for by the Biosoma-induced increase in peripheral conversion of T4 to T3 GH therapy improved the patients' general condition, appearance, muscle force, and mental status.