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Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.
SUMMARIES FOR PATIENTS
The Effects of Growth Hormone Treatment on Cardiac Risk Factors in Men with Low Growth Hormone Levels
18 July 2000 | Volume 133 Issue 2 | Page 111
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians-American Society of Internal Medicine.
The summary below is from the full report titled "Effects of Growth Hormone Administration on Inflammatory and Other Cardiovascular Risk Markers in Men with Growth Hormone Deficiency. A Randomized, Controlled Clinical Trial." It is in the 18 July 2000 issue of Annals of Internal Medicine (volume 133, pages 111-122). The authors are G. Sesmilo, B.M.K. Biller, J. Llevadot, D. Hayden, G. Hanson, N. Rifai, and A. Klibanski.
What is the problem and what is known about it so far?
Growth hormone comes from a gland called the pituitary, located under the brain. It controls growth in children. In adults, it regulates the way the body uses fats and carbohydrates. Adults with low growth hormone levels have a greater risk for heart attacks and strokes than adults with normal levels. Low levels are also associated with risk factors for cardiovascular disease, including abdominal obesity, insulin resistance, and unfavorable levels of cholesterol and related fats. Inflammation may cause or aggravate cardiovascular disease. Growth hormone helps to regulate inflammation, and patients with low growth hormone levels may also be at increased risk for cardiovascular disease because inflammation is not properly controlled. It is unknown whether growth hormone treatment in adults with low levels of growth hormone improves these cardiovascular risk factors.
Why did the researchers do this particular study?
To find out whether giving growth hormone to adults with low levels of this hormone improves risk factors for cardiovascular disease.
Who was studied?
Forty adult men with low growth hormone levels. All of the men developed their low growth hormone levels during adulthood.
How was the study done?
The researchers assigned each man to receive daily injections of growth hormone or a placebo. The placebo looked like the growth hormone preparation but contained no active ingredients. The researchers measured cardiovascular risk factors before the injections were started and after 1, 3, 6, 12, and 18 months of treatment. Measurements included body fat, insulin resistance, the way the body handles carbohydrates, blood levels of cholesterol and related fats, and the amount of inflammation in the body (tested by levels of C-reactive protein and interleukin-6).
What did the researchers find?
Treatment with growth hormone was associated with improvements in some cardiovascular risk factors, particularly the distribution of body fat and the tests related to inflammation. Cholesterol levels improved during the first 3 months, but this improvement did not last.
What were the limitations of the study?
This study did not follow patients long enough to see whether treatment actually decreased the rate of heart attacks and strokes. No serious side effects occurred during the 18 months of the study, but it is unknown whether they might occur with longer treatment. The study did not include women and cannot provide information on women's response to this treatment.
What are the implications of the study?
Giving growth hormone injections to men with low growth hormone levels leads to some improvements in risk factors for cardiovascular disease. More studies are needed to see whether treatment causes fewer bad health events and to understand the effects of growth hormone treatment on cardiovascular risk factors in women.
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