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GH treatment in adults with chronic liver disease: A randomized, double-blind, placebo-controlled, cross-over study
Wallace, J. D., Abbott-Johnson, W. J., Crawford, D. H. G., Barnard, R., Potter, J. M. and Cuneo, R. C. (2002) GH treatment in adults with chronic liver disease: A randomized, double-blind, placebo-controlled, cross-over study. Journal of Clinical Endocrinology And Metabolism, 87 6: 2751-2759.
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| Author(s) |
Wallace, J. D.
Abbott-Johnson, W. J.
Crawford, D. H. G.
Barnard, R.
Potter, J. M.
Cuneo, R. C.
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| Title |
GH treatment in adults with chronic liver disease: A randomized, double-blind, placebo-controlled, cross-over study
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| Journal name |
Journal of Clinical Endocrinology And Metabolism
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| Publication date |
2002
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| Volume number |
87
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| Issue number |
6
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| ISSN |
0021-972X
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| Start page |
2751
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| End page |
2759
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| Total pages |
9
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| Place of publication |
Bethesda
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| Publisher |
Endocrine Society
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| Collection year |
2002
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| Language |
eng
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| Subject |
C1
321004 Endocrinology
730105 Endocrine organs and diseases (incl. diabetes)
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| Abstract |
Patients with chronic liver disease (CLD) are catabolic and GH-resistant. The effects of supraphysiological recombinant human GH (rhGH; 0.2 IU.kg(-1).d(-1)) treatment in adults with CLD were assessed in a randomized, double-blind, placebo-controlled cross-over trial (4-wk dietary run-in, 4-wk treatment, and 2-wk wash-out phases). Nine adults with mild- to moderate-severity CLD participated (median age, 49 yr; three males and six females; Child's classification A in six and B in three). Biopsy-proven etiologies were: alcohol (four patients), primary biliary cirrhosis (three patients), non-A, non-B, non-C hepatitis (one patient), and cryptogenic (one patient). Treatment with rhGH increased serum IGF-I (median increase over placebo, +93 mug.liter(-1); P = 0.004), IGF-binding protein-3 (+0.9 mg.liter(-1): P = 0.004), and acid labile subunit (+10.7 nM; P = 0.004). Total body potassium (+8.0 g; P = 0.023), body weight (+1.6 kg; P = 0.008), and total body water (by bioelectrical impedance; +4.9 kg; P = 0.004) increased. Resting metabolic rate (+313 ml.kg(-1).min(-1); P = 0.004) and lipid oxidation (+1072.0 kcal.d(-1); P = 0.032) increased. Metabolic changes included increased fasting plasma glucose (+1.2 mm; P = 0.008), insulin (+33.8 mU.liter(-1); P = 0.004), C-peptide (+0.7 nM; P = 0.004), and free-fatty acids (+0.1 mEq.liter(-1); P = 0.04). Clinical side effects included worsening edema and ascites. Hepatocellular function did not change. Therefore, rbGH treatment in CLD: 1) overcame hepatic GH resistance; 2) may have improved whole-body protein catabolism; 3) increased lipolysis and lipid oxidation; 4) increased insulin resistance; and 5) had potent antinatriuretic effects. Long-term safety and efficacy require further assessment.
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| Keyword(s) |
Endocrinology & Metabolism
Growth-factor-i
Hormone-binding-protein
Deficient Adults
Body-composition
Energy-expenditure
Circulating Levels
Cirrhotic Liver
Skeletal-muscle
Igf-i
Insulin
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