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Pouneh K. Fazeli, Elizabeth A. Lawson, Rajani Prabhakaran, Karen K. Miller, Daniel A. Donoho, David R. Clemmons, David B. Herzog, Madhusmita Misra, Anne Klibanski, Effects of Recombinant Human Growth Hormone in Anorexia Nervosa: A Randomized, Placebo-Controlled Study, The Journal of Clinical Endocrinology & Metabolism, Volume 95, Issue 11, 1 November 2010, Pages 4889–4897, https://doi.org/10.1210/jc.2010-0493
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Context: Anorexia nervosa (AN), a state of chronic nutritional deprivation, is characterized by GH resistance with elevated GH levels and decreased levels of IGF-I. The effects of supraphysiological recombinant human GH (rhGH) on GH resistance in AN are not currently known.
Objective: The aim was to investigate whether supraphysiological rhGH increases IGF-I levels in AN.
Design and Setting: We conducted a randomized, placebo-controlled study in a Clinical Research Center.
Patients: We studied 21 women with AN, 10 (mean age, 28 ± 2.1 yr) treated with rhGH and 11 (mean age, 29.2 ± 2.6 yr) treated with placebo.
Interventions: rhGH (mean maximum daily dose, 1.4 ± 0.12 mg/d) or placebo was administered to patients for 12 wk.
Main Outcome Measures: IGF-I, N-terminal propeptide of type 1 procollagen, type I collagen C-telopeptide, glucose, and insulin levels were measured at wk 0, 1, 2, 3, 4, 8, and 12; C-terminal propeptide of type 1 procollagen, leptin, and free fatty acid levels were measured at wk 0 and 12. Body composition, including total fat and lean mass, was measured by dual-energy x-ray absorptiometry at wk 0 and 12.
Results: IGF-I levels did not differ between the groups at baseline or after treatment (median after 12 wk—rhGH, 124 ng/ml, interquartile range, 94.5, 170.3; vs. placebo, 85.5 ng/ml, interquartile range, 62, 139; P = 0.3). Similarly, changes in glucose, insulin, free fatty acids, and bone markers did not differ between the groups. Total fat mass and percentage fat mass (rhGH, −2.5 ± 0.6%, vs. placebo, 2.2 ± 1.1%; P = 0.004) decreased significantly in the rhGH group compared to placebo despite comparable weight.
Conclusions: Supraphysiological rhGH administration decreases fat mass in AN without increasing IGF-I levels, supporting the role of GH as a mediator of lipolysis independent of IGF-I.
