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dc.contributor.authorAbdul Shakoor, S K
dc.contributor.authorShalet, Stephen M
dc.date.accessioned2009-08-26T16:06:24Z
dc.date.available2009-08-26T16:06:24Z
dc.date.issued2003-09
dc.identifier.citationEffects of GH replacement on metabolism and physical performance in GH deficient adults. 2003, 26 (9):911-8 J. Endocrinol. Invest.en
dc.identifier.issn0391-4097
dc.identifier.pmid14964445
dc.identifier.urihttp://hdl.handle.net/10541/78757
dc.description.abstractGH deficiency (GHD) in adults is associated with abnormalities in body composition, metabolic derangements, sub-optimal physical performance, high incidence of adverse cardiovascular risk factors and poor quality of life. GHD adults are insulin resistant and have reduced hepatic glycogen stores, reduced insulin stimulated glucose utilization and reduced glycogen synthesis in muscle. GH replacement results in either no change or slight reduction in insulin sensitivity. Hence, it is important to monitor for the development of glucose intolerance in patients on long-term GH replacement. GHD is associated with a lipid profile known to predispose to premature atherosclerosis and cardiovascular disease, i.e. increased total and LDL cholesterol, decreased HDL cholesterol, increased small dense LDL particles and increased triglycerides. LDL-cholesterol abnormalities appear to improve with GH replacement even if maintained within physiological dose range; the greatest improvement occurs in those subjects with higher baseline total and LDL cholesterol values and in female patients with adult onset GHD compared with male patients with childhood onset GHD. In contrast, hypertriglyceridaemia is not corrected by GH replacement. The majority of the reports suggest GH replacement increases Lipoprotein-a levels. Long-term observation will be required to determine whether GH replacement reduces cardiovascular morbidity and mortality in GHD adults. The reduced muscle mass and strength associated with GHD has been shown to improve after GH replacement. GH treatment also improves maximal and sub-maximal exercise performance in GHD adults. The effects on protein metabolism, energy expenditure and thyroid metabolism in GHD adults are also critical.
dc.language.isoenen
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshBody Composition
dc.subject.meshCarbohydrate Metabolism
dc.subject.meshCardiovascular Diseases
dc.subject.meshCholesterol, LDL
dc.subject.meshEnergy Metabolism
dc.subject.meshExercise
dc.subject.meshFemale
dc.subject.meshHuman Growth Hormone
dc.subject.meshHumans
dc.subject.meshHypoglycemic Agents
dc.subject.meshInsulin
dc.subject.meshInsulin Resistance
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshMuscle, Skeletal
dc.subject.meshPhysical Fitness
dc.subject.meshRisk Factors
dc.titleEffects of GH replacement on metabolism and physical performance in GH deficient adults.en
dc.typeArticleen
dc.contributor.departmentDepartment of Endocrinology, Christie Hospital, Manchester, UK.en
dc.identifier.journalJournal of Endocrinological Investigationen
html.description.abstractGH deficiency (GHD) in adults is associated with abnormalities in body composition, metabolic derangements, sub-optimal physical performance, high incidence of adverse cardiovascular risk factors and poor quality of life. GHD adults are insulin resistant and have reduced hepatic glycogen stores, reduced insulin stimulated glucose utilization and reduced glycogen synthesis in muscle. GH replacement results in either no change or slight reduction in insulin sensitivity. Hence, it is important to monitor for the development of glucose intolerance in patients on long-term GH replacement. GHD is associated with a lipid profile known to predispose to premature atherosclerosis and cardiovascular disease, i.e. increased total and LDL cholesterol, decreased HDL cholesterol, increased small dense LDL particles and increased triglycerides. LDL-cholesterol abnormalities appear to improve with GH replacement even if maintained within physiological dose range; the greatest improvement occurs in those subjects with higher baseline total and LDL cholesterol values and in female patients with adult onset GHD compared with male patients with childhood onset GHD. In contrast, hypertriglyceridaemia is not corrected by GH replacement. The majority of the reports suggest GH replacement increases Lipoprotein-a levels. Long-term observation will be required to determine whether GH replacement reduces cardiovascular morbidity and mortality in GHD adults. The reduced muscle mass and strength associated with GHD has been shown to improve after GH replacement. GH treatment also improves maximal and sub-maximal exercise performance in GHD adults. The effects on protein metabolism, energy expenditure and thyroid metabolism in GHD adults are also critical.


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