Growth hormone replacement – wonder what it is about? You can read it more through this page.
Growth hormone replacement has a special role to play when it comes to human growth hormone deficiency. Some of you may tend to wonder what the relationship between the treatment and the disorder is. These are further elaborated in the following subsections.
Acquired Growth Hormone Deficiency
Acquired growth hormone (GH) deficiency arises from the defect of the normal pituitary or hypothalamic tissue. It is also known that acquired GH deficiency is related with the changes in body composition, lipid metabolism, bone density, cardiovascular function and physical performance.
Acquired GH deficiency symptoms are weight gain, increased fat mass and a decreased lean body mass. A study showed that the total body fat is increased by 7% and the lean body mass is also decreased to the same degree. The increased fat mass is in a truncal distribution, making an increased waist hip ratio. The triglyceride levels are also increased while HDL levels are decreased. The increased lipid level is partly explained by the increased vascular thickness measured by carotid ultrasonography. All of these may likely contribute to the increased incidence of cardiovascular mortality in patients having GH deficiency.
In GH-deficient patients, muscle mass and muscle strength are diminished. The effect of these changes in the heart is a reduced left ventricles mass, decreased fractional shortening of cardiac myocytes, and a decreased cardiac output. This abnormality contributes to the striking decline in exercise capacity. In a recent study, the exercise capacity as assessed by cycle ergometry is decreased by 20-25%. In GH-deficient patient, his bone density is reduced. According to a recent study, the cortical bone density and spinal bone density were 2.8 and 1.5 standard deviations below the mean as for age and sex matched controls.
Lastly, GH deficiency patients is said to have impaired psychological well being and neuropsychiatric manifestations, like memory impairment and lack of concentration. Self-rating questionnaires shows reduced vitality, fatigue, depression and social isolation.
Growth Hormone Replacement for Acquired GH Deficiency
Recombinant human growth hormone therapy can be a therapeutic option among adults with acquired GH deficiency. The metabolic and psychological abnormalities related with GH deficiency can be reversed with GH replacement. Like for example in body composition where fat mass is reduced and lean body mass is increased.
Growth hormone even in a low dose of 0.003 mg/kg can normalize lean body mass within 6 months in 24 adults having GH deficiency. The improvement in lean body mass is due to increased protein synthesis, muscle function and muscle mass. The total body fat mass can also decrease within 6 months of GH administration.
Failure in fat mass usually occurs in visceral and trunk locations as compared to the neck, arms and legs. Therefore, it is suggested that GH replacement therapy will reverse the truncal redistribution of fat mass related with GH deficiency and impact on cardiovascular risk. GH replacement affects lipid metabolism as in short courses of GH reduced LDL cholesterol causing an increased mRNA expression of the LDL receptor in the liver.
The Functions of Growth Hormone Replacement
GH is said to stimulate thymidine incorporation and osteoblast proliferation in vitro. GH also stimulates systemic as well as local production of Insulin-Like Growth Factor 1, another known bone mitogen. Recent study shows that GH replacement increases Gla-protein, a sensitive indicator of osteoblast function. However, the use of quantitative tomography and single photon absorptiometry increases 5% and 4% in spinal and cortical bone density within 12 months of therapy among adults who are GH-deficient.
There is also an improvement in exercise capacity and cardiac function among GH-deficient patients having growth hormone replacement. Patients increased oxygen uptake and power output, thus increases skeletal muscle mass and improve cardiac function. With all these said about this HGH treatment, one can say that GH replacement can be of great help.
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