• Assessment of Growth Hormone Physiology in the HIV Lipodystrophy Syndrome
  Steven Grinspoon
• The Effects of Recombinant Human Growth Hormone (GH) on Glucose Metabolism and Body Composition in HIV-Positive Subjects with Fat Accumulation (FA) Syndromes
  Joan Lo

There were then two presentations related to growth hormone. In the first presentation, Steve Grinspoon from Harvard looked at the regulation of growth hormone in patients with lipodystrophy. He demonstrated the association between visceral adiposity and low concentrations of growth hormone. Although, to me, it is still unclear which comes first: the low growth hormone that increases the abdominal fat, or the other way around. Some patients with lipodystrophy -- perhaps only one third of them -- might benefit from supplementation.

Then Joan Lo presented data from a small clinical trial with seven patients with evidence of lipodystrophy. They were treated with 3 mg a day of growth hormone (a dose between the huge doses used in wasting syndrome and the more "physiologic" doses). The group also checked insulin sensitivity, oral glucose tolerance, and body composition (DEXA) at baseline, month one and month six. In spite of the fact that persons with diabetes and elevated triglycerides were excluded from the study, one subject had to quit at week three due to hyperglycemia. Five people completed six months of HGH, with a dose reduction to 1.5 mg in one patient at month two for arthralgias. All five people experienced a reduction in hump size and/or abdominal girth. The lean body mass increased (the muscles) but, unfortunately, the patients continued to loose subcutaneous fat. These results are quite preliminary and we need well-designed randomized trials before recommending the use of growth hormone for this indication.