Effect of short-term growth hormone and testosterone administration on body composition and glucose homeostasis in men receiving chronic glucocorticoid therapy.

• OBJECTIVE: Long-term pharmacological glucocorticoid (GC) therapy leads to skeletal muscle atrophy and weakness. The objective of this study was to investigate whether short-term treatment with growth hormone (GH) and testosterone (T) can increase lean mass without major impairment of glucose homeostasis in patients on GC therapy. DESIGN, MATERIALS AND METHODS: This was a prospective, open-label, randomized, crossover study. Twelve men (age 74±6 years) on chronic GC treatment participated. The effects of two weeks treatment with GH, testosterone and the combination of both, on lean body mass (LBM), appendicular skeletal muscle mass (ASMM), extracellular water (ECW), body cell mass (BCM) and plasma glucose concentrations were investigated. RESULTS: LBM increased significantly after GH (Δ1.7±1.4 kg; P=0.007) and GH+T (Δ2.4±1.1 kg; P=0.003), but not T alone. ASMM increased after all three treatment periods; by 1.0±0.8 kg after GH (P=0.005), 1.7±0.4 kg after GH+T (P=0.002) and 0.8±1.0 kg after T (P=0.018). The increase in ASMM was larger with combined treatment than either GH or T alone (P<0.05). ECW increased significantly after GH+T by 1.5±2.6 L (P=0.038) but not after GH or T alone. BCM increased slightly after single and combined treatments but the changes were not significant. Fasting glucose increased significantly after GH (Δ0.4±0.4 mmol/L, P=0.006) while both fasting (Δ0.2±0.3 mmol/L, P=0.045) and post glucose-load (Δ1.8±2.3 mmol/L, P=0.023) plasma glucose concentrations increased after GH+T. CONCLUSIONS: GH and T induce favourable and additive body compositional changes in men on chronic, low-dose GC treatment. In the doses used, combination therapy increases fasting and postprandial glucose concentration.

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MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)

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