AN OPEN 36-MONTH STUDY OF LIPID CHANGES WITH GROWTH-HORMONE IN ADULTS- LIPID CHANGES FOLLOWING REPLACEMENT OF GROWTH-HORMONE IN ADULT ACQUIRED GROWTH-HORMONE DEFICIENCY

Interest in adult growth hormone replacement has increased since ident ification of the associated vascular morbidity and mortality. Although total cholesterol and low density lipoprotein reduction and high dens ity Lipoprotein increases are anticipated, reports are conflicting and there is no uniformity in lipoprotein(a) changes. In 1990 we commence d an open trial of therapy with human recombinant. GH and now have res ults to 36 months for 21 patients. Deficiency status was confirmed by insulin stress test with nat GH response < 2.0 ng/ml, mean insulin-lik e growth factor-I value 122 ng/ml (+/- 69 SD). Lipoprotein(a) was meas ured by monoclonal assay. Lipid analysis yields two subgroups: baselin e cholesterol levels of greater or less than 6.22 mmol/l, with hyperch olesterolaemic patients showing an enhanced hypolipaemic response. ANO VA was utilized, with 95% confidence limits. The most significant chan ges are of reductions in cholesterol and low density lipoprotein; the rate of change is greatest at 6 and 12 months but not sustained to 36 months. High density lipoprotein rises as expected, not to full signif icance. Lipoprotein(a) levels rose significantly in six patients of th e cohort, and the increase was sustained over 36 months.