AIDSWEEKLY Plus; Monday, June 20, 2005
Staff Medical Writers

"Growth hormone-releasing hormone (GHRH) is a potentially appealing strategy to simultaneously improve fat distribution and increase bone turnover in HIV-infected patients.

"We investigated the effects of GHRH (1 mg subcutaneously twice a day over 12 weeks) in 31 HIV-infected men with abdominal fat accumulation (age 46±1 year, body mass index 26.2±0.6 kg/m²) in a randomized, double-blind, placebo-controlled study," researchers in the United States report.

"We previously reported significant effects of GHRH on IGF-I and truncal fat. In this study, we assessed whether GHRH increased markers of bone turnover. At baseline, 32% of our subjects (n=10) demonstrated a bone density Z score less than -1.0 SD and greater than or equal to-2.5 SD, and 3% (n=1) demonstrated a Z score of less than -2.5 SD.

"IGF-I correlated with N-terminal telopeptide (NTx) (r=0.49, p=0.005) and tended to correlate with C-terminal telopeptide (CTx) (r=0.35, p=0.06) at baseline," said the authors.

"Of the bone resorption markers, CTx increased significantly (0.16±0.07 vs. -0.03±0.03 ng/mL, GHRH vs. placebo, p=0.02), and NTx tended to increase in response to GHRH (2.8±1.4 vs. -0.5±1.0 nM bone collagen equivalent, GHRH vs. placebo, p=0.07).

"Of the bone formation markers," continued scientists, "N-terminal propeptide of type 1 procollagen increased (14.6±9 vs. -6.8±3.1 mcg/L, GHRH vs. placebo, p=0.03) and osteocalcin tended to increase (8.4±3.0 vs. 2.0±1.6 ng/mL, GHRH vs. placebo, p=0.06) in response to GHRH."

"The calciotropic hormones, calcium and phosphorus, did not change significantly. The change in IGF-I correlated with the change in NTx (r=0.45, p=0.02), CTx (r=0.38, p=0.05), and osteocalcin (r=0.55, p=0.002)," said P. Koutkia and colleagues at Harvard University.

Koutkia concluded, "GHRH improves fat distribution and bone metabolism in men with HIV-related fat accumulation. Long-term studies are needed to determine whether the stimulatory effects of GHRH on bone turnover will translate into increased bone density in this population."

Koutkia and colleagues published their study in the Journal of Clinical Endocrinology and Metabolism (Effects of growth hormone-releasing hormone on bone turnover in human immunodeficiency virus-infected men with fat accumulation. J Clin Endocrinol Metab, 2005;90(4):2154-2160).

For additional information, contact S. Grinspoon, Harvard University, Massachusetts General Hospital, School of Medicine, Program Nutrition Metab, 55 Fruit St., LON 207, Boston, MA 02114, USA.

Publisher contact information for the Journal of Clinical Endocrinology and Metabolism is: Endocrine Society, 8401 Connecticut Avenue, Suite 900, Chevy Chase, MD 20815-5817, USA.

Keywords: Boston, Massachusetts, United States, HIV/AIDS, Growth Hormone Releasing Hormone, HAART-Related Lypodystrophy, Bone Turnover.

This article was prepared by AIDS Weekly editors from staff and other reports.

Reference

Koutkia P, Canavan B, Breu J, et al., Effects of growth hormone-releasing hormone on bone turnover in human immunodeficiency virus-infected men with fat accumulation, J Clin Endocrinol Metab. 2005 Apr;90(4):2154-60.

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