Effects of a Combination of rhGH and Metformin on Adiponectin Levels in Patients With Metabolic Syndrome

Horm Metab Res. 2005 Jan;37(1):49-52. doi: 10.1055/s-2005-861036.

Abstract

Adiponectin is a recently discovered adipocytokine that correlates negatively with body mass index and body fat. In patients with GH deficiency, treatment with recombinant human growth hormone (rhGH) reduces body fat mass and thus may also have a favorable effect in patients with metabolic syndrome, and would also be expected to increase adiponectin levels. However, due to its diabetogenic effect, rhGH treatment also bears an increased risk for the development of type 2 diabetes mellitus. We conducted a 18-month randomized, double-blind, placebo-controlled study to assess the effect of rhGH in combination with metformin (MGH) in 14 obese men (7 MGH; 7 Metformin+Placebo, 54 +/- 2 years, BMI 33.0 +/- 1.2 kg/m(2)) with mildly elevated fasting plasma glucose (FPG) at screening (6.1-8.0 mmol/l). All patients received metformin (850 mg twice daily) for treatment of type 2 diabetes mellitus/impaired glucose tolerance, either alone or in combination with rhGH (daily dose 9.5 mug/kg body weight). Glucose disposal rate (GDR) was measured using the euglycemic hyperinsulinemic clamp technique, and body composition was measured by DEXA at 0 and 18 months. After 18 months, the mean adiponectin concentration increased by 32 +/- 11 % (p = 0.018) in the MGH group and did not change in the MP group (- 10 +/- 13 %; p = n. s.). The difference in relative changes in adiponectin levels between the two groups after 18 months was statistically significant (p = 0.026). Improvement in insulin sensitivity (GDR) correlated positively with adiponectin levels (r = 0.73; p = 0.004). In conclusion, the additional administration of rhGH increased adiponectin levels in patients with metabolic syndrome, indicating its potential role in adiponectin-associated insulin sensitivity alterations.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiponectin
  • Body Composition
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / chemically induced
  • Diabetes Mellitus, Type 2 / prevention & control
  • Double-Blind Method
  • Drug Therapy, Combination
  • Human Growth Hormone / administration & dosage*
  • Human Growth Hormone / adverse effects
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Insulin Resistance
  • Insulin-Like Growth Factor I / analysis
  • Intercellular Signaling Peptides and Proteins / blood*
  • Male
  • Metabolic Syndrome / blood*
  • Metabolic Syndrome / complications
  • Metabolic Syndrome / drug therapy*
  • Metformin / administration & dosage*
  • Middle Aged
  • Obesity / blood*
  • Obesity / complications
  • Obesity / drug therapy
  • Prospective Studies
  • Recombinant Proteins

Substances

  • Adiponectin
  • Hypoglycemic Agents
  • Intercellular Signaling Peptides and Proteins
  • Recombinant Proteins
  • Human Growth Hormone
  • Insulin-Like Growth Factor I
  • Metformin