{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T19:23:04Z","timestamp":1779909784972,"version":"3.53.1"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2001,12,24]],"date-time":"2001-12-24T00:00:00Z","timestamp":1009152000000},"content-version":"vor","delay-in-days":449,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2000,10]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>To study the effects of short (6 months) and longer\u2010term (up to 24 months) growth hormone (GH) replacement therapy using a dose titration regimen, on lipid and glucose metabolism in GH\u2010deficient, hypopituitary adults.<\/jats:p><\/jats:sec><jats:sec><jats:title>DESIGN<\/jats:title><jats:p>On\u2010going open study of GH treatment up to 24 months. Measurements were performed at baseline and at 6, 12, 18 months and 2 years during therapy (data shown at 6 months and 2 years only). Using a dose titration regimen the median GH dose used to achieve and maintain IGF\u2010I levels above the median, but below the upper limit of the age\u2010related reference range (median IGF\u2010I 202.5\u2003\u03bcg\/l, range 76\u2013397\u2003\u03bcg\/l), was 1.2\u2003IU daily (range 0.4\u20133\u2003IU) [0.8\u2003IU\/day, males; 1.6\u2003IU\/day, females].<\/jats:p><\/jats:sec><jats:sec><jats:title>PATIENTS<\/jats:title><jats:p>Ninety GH\u2010deficient hypopituitary adults (54 female, median age 48 years, range 19\u201379 years) entered the study and 24 (14 female, median age 45 years, range 32\u201379 years) have concluded the 2 year period of assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>MEASUREMENTS<\/jats:title><jats:p>Body mass index (BMI), waist and hip circumference ratio (WHR), fasting lipids, glucose and glycated haemoglobin (HbA<jats:sub>1c<\/jats:sub>) levels were measured at 6 month intervals during GH therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Using the dose titration regimen, compared to pretreatment values, total and low density lipoprotein (LDL)\u2010cholesterol levels were significantly lower at 6 months (mean \u00b1\u2003SEM, 5.61\u2003\u00b1\u20030.1 <jats:italic>vs<\/jats:italic>. 5.25\u2003\u00b1 0.1, and 3.85\u2003\u00b1\u20030.19 <jats:italic>vs<\/jats:italic>. 3.43\u2003\u00b1\u20030.26, respectively, <jats:italic>P<\/jats:italic>\u2003&lt;\u20030.05), and were maintained throughout the study. Male patients had significantly lower pretreatment total and LDL cholesterol levels than females (mean \u00b1\u2003SEM, 5.33\u2003\u00b1\u20030.16\u2003mmol\/l <jats:italic>vs<\/jats:italic>. 5.7\u2003\u00b1\u20030.12\u2003mmol\/l and 3.8\u2003\u00b1\u20030.23\u2003mmol\/l <jats:italic>vs<\/jats:italic>. 3.92\u2003\u00b1\u20030.29\u2003mmol\/l, respectively, <jats:italic>P<\/jats:italic>\u2003&lt;\u20030.05). A decrease in total cholesterol was confined to patients with pretreatment total cholesterol levels above 5.8\u2003mmol\/l; patients with the highest pretreatment cholesterol levels (&gt;\u20036.4\u2003mmol\/l) obtained the greatest cholesterol reduction (mean \u00b1\u2003SEM, 7.13\u2003\u00b1 0.14\u2003mmol\/l <jats:italic>vs<\/jats:italic>. 5.76\u2003\u00b1\u20030.31\u2003mmol\/l, <jats:italic>P<\/jats:italic>\u2003&lt;\u20030.05). A cholesterol\u2010lowering effect of GH therapy was evident in patients who had elevated pre\u2010GH total cholesterol levels even if they were already receiving and continuing lipid lowering medication (mean \u00b1\u2003SEM, 5.62\u2003\u00b1\u20030.22 <jats:italic>vs<\/jats:italic>. 5.03\u2003\u00b1\u20030.285, <jats:italic>P<\/jats:italic>\u2003&lt;\u20030.05). A modest increment in high density lipoprotein (HDL)\u2010cholesterol was evident at 18 months but there was no significant change in triglycerides at any time point. Fasting plasma glucose increased significantly at 6 months but remained within the reference range. Glycated haemoglobin increased significantly at 6 months and was maintained throughout the study; one patient developed frank diabetes mellitus while receiving treatment. There was a weak but significant correlation between the increment in glycated haemoglobin and pretreatment BMI (<jats:italic>r<\/jats:italic>\u2003=\u2003+\u20030.215, <jats:italic>P<\/jats:italic>\u2003&lt;\u20030.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>The effect of GH on lowering total and low density lipoprotein\u2010cholesterol is more prominent in patients with higher pretreatment cholesterol levels and is evident even in patients receiving other lipid\u2010lowering medication. A modest increment in mean fasting glucose (within the reference range) and mean glycated haemoglobin persisted throughout the study. One patient developed diabetes mellitus. A GH replacement regimen using low dose and careful titration to avoid elevated IGF\u2010I levels and adverse effects is associated with sustained beneficial effects on circulating lipids.<\/jats:p><\/jats:sec>","DOI":"10.1046\/j.1365-2265.2000.01108.x","type":"journal-article","created":{"date-parts":[[2003,3,11]],"date-time":"2003-03-11T10:46:30Z","timestamp":1047379590000},"page":"453-459","source":"Crossref","is-referenced-by-count":48,"title":["Sustained reduction in circulating cholesterol in adult hypopituitary patients given low dose titrated growth hormone replacement therapy: a two year study"],"prefix":"10.1111","volume":"53","author":[{"given":"Dimos","family":"Florakis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Hung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Kaltsas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna","family":"Coyte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul J.","family":"Jenkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shern L.","family":"Chew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley B.","family":"Grossman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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