8th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV San Francisco, California - September 24 - 26, 2006

IMPAIRED GROWTH HORMONE SECRETION IN WOMEN WITH HIV-RELATED LIPODYSTROPHY

Antiviral Therapy 2006; 11:L29 (abstract no. 44)

G Guaraldi¹, G Orlando¹, N Squillace¹, V Rochira², L Zirilli², C Diazzi², G Caffagni², A Balestrieri², ARM Granata², MC De Santis³ and GC Carani^2
1Department of Medicine and Medical Specialties, Clinics of Infective Diseases, University of Modena and Reggio Emilia, Modena, Italy; ²Department of Medicine, Endocrinology and Metabolism, Geriatrics, University of Modena and Reggio Emilia, Modena, Italy; ³Laboratory of Endocrinology, Policlinico of Modena, Italy

Approximately 20% of male patients with HIV-related lipodystrophy present with an inadequate peak of growth hormone (GH) secretion in response to GHRH-arginine testing (Koutkia 2005), which is strongly and inversely related to visceral adipose tissue (VAT). Our aim is to investigate GH secretion in female patients with HIV-related lipodystrophy according to their body composition.

We included in this study 35 HIV-infected female patients (mean age 44.6 ±7.6 SD) with lipodystrophy. We investigated their GH response to standardised GHRH-arginine in order to compare it with total body fat expressed as body mass index (BMI), VAT and subcutaneous adipose tissue (SAT), evaluated by CT scan. We considered a severely impaired GH secretion (IGHS) when the GH peak in response to GHRH-arginine stimulation was ≤5 µg/l; a mildly IGHS when it was >5 µg/l but <9 µg/l, and a normal GH secretion with a peak ≥9 µg/L. The threshold has been established on the basis of current clinical guidelines for the diagnosis of GH deficiency in adults (Aimaretti 1998), according to the degree of obesity (Corneli 2005), together with preliminary data obtained in male HIV-related lipodystrophy.

Our data show that 37.5% of our patients had IGHS (12.5% – a severe IGHS, 25% – the mild form). The mean results ±SD of the three groups are displayed in Table 1. This study suggests that pituitary GH secretion may be impaired in HIV-infected women. The percentage of subjects with IGHS seems to be higher in HIV-infected women than in men (Koutkia 2005). IGF-1 results lower in IGHS subjects. Furthermore, body composition does not change according to GH-peak status.

Table 1. (Abstract 44)

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2006-09-24
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