Growth hormone-releasing hormone in HIV-infected men with lipodystrophy: a randomized controlled trial

JAMA. 2004 Jul 14;292(2):210-8. doi: 10.1001/jama.292.2.210.


Context: Reduced growth hormone (GH) concentrations are observed in men with human immunodeficiency virus (HIV) lipodystrophy.

Objective: To investigate the effects of growth hormone-releasing hormone (GHRH), a GH secretagogue, in treatment of HIV lipodystrophy.

Design, setting, and participants: Randomized, double-blind, placebo-controlled trial conducted at a research center in the United States between October 2002 and June 2003 and enrolling 31 HIV-infected men aged 18 to 60 years with evidence of lipodystrophy.

Interventions: Participants were assigned to receive GHRH (1 mg subcutaneously twice daily) or placebo for 12 weeks.

Main outcome measures: The primary outcome was change in concentrations of insulin-like growth factor 1 (IGF-1) to detect overall change in GH levels in response to GHRH. Secondary end points included body composition by dual-energy x-ray absorptiometry and computed tomography, lipodystrophy ratings, and levels of glucose, insulin, and lipids.

Results: Mean (SD) IGF-1 concentrations increased significantly in the GHRH group vs the placebo group (104 [110] ng/mL vs 6 [44] ng/mL, P =.004). Lean body mass significantly increased in the GHRH group vs the placebo group (0.9 [1.3] kg vs -0.3 [1.7] kg, P =.04), trunk fat significantly decreased (-0.4 [0.7] kg vs 0.2 [0.6] kg, P =.03), and the ratio of trunk to lower extremity fat improved significantly (-0.22 [0.32] vs 0.14 [0.29], P =.005). Abdominal visceral fat was reduced (-19.2 [36.6] cm2 vs 2.3 [24.3] cm2, P =.07) and the ratio of abdominal visceral fat to abdominal subcutaneous fat improved significantly more in the GHRH group (-0.19 [0.28] vs 0.07 [0.27], P =.02). Both physician and patient rating of lipodystrophy in the arms, legs, and abdomen also improved significantly. Levels of glucose, insulin, and lipids did not change significantly.

Conclusions: GHRH was well tolerated and effectively increased levels of IGF-1 in HIV-infected men with lipodystrophy. Total and regional body composition improved in response to GHRH, with increased lean mass and reduced truncal and visceral fat. Use of GHRH may potentially be a beneficial treatment strategy for this population.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Blood Glucose
  • Body Composition
  • Double-Blind Method
  • Growth Hormone-Releasing Hormone / therapeutic use*
  • HIV Infections / metabolism
  • HIV-Associated Lipodystrophy Syndrome / drug therapy*
  • HIV-Associated Lipodystrophy Syndrome / metabolism*
  • Humans
  • Insulin / blood
  • Insulin-Like Growth Factor I / metabolism
  • Lipids / blood
  • Male
  • Middle Aged


  • Blood Glucose
  • Insulin
  • Lipids
  • Insulin-Like Growth Factor I
  • Growth Hormone-Releasing Hormone