Growth hormone treatment prevents loss of lean mass after bariatric surgery in morbidly obese Patients

Results of a pilot, open, prospective, randomized, controlled study

Silvia Savastano, Carolina Di Somma, Luigi Angrisani, Francesco Orio, Salvatore Longobardi, Gaetano Lombardi, Annamaria Colao

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Context: The loss of lean body mass (LBM) negatively influences the outcome in bariatric surgery. Impaired GH secretion is frequent in obese patients. Objective: Our objective was to investigate if GH treatment prevents LBM loss in the early postoperative period. Design: This was an open, prospective, randomized, and controlled study. Patients: A total of 24 women (body mass index: 44.4 ± 7.6 kg/m2, aged 36.8 ± 11.7yr) undergoing laparoscopic-adjustable silicone gastric banding (LASGB) and with GH deficiency after LASGB was included in the study. Treatment Protocol: Group A (n = 12) included a standardized diet regimen and exercise program plus recombinant human GH (0.5 ± 0.13 mg every day), and group B (n = 12) included a standardized diet regimen and exercise program. The follow-up duration was 6 months. Results: The excess of body weight loss did not differ between groups A and B after 3 and 6 months. At 3 months, LBM loss was lower (P <0.0001) and fat mass (FM) loss was higher (P = 0.02) in group A than group B. At 3 and 6 months, appendicular skeletal muscle mass loss was lower (P = 0.000) in group A than group B. At 3 (P = 0.0003 and 0.0005, respectively) and 6 months (P <0.0001 and 0.0002, respectively), the percent changes of FM and lean body mass were significantly higher in group A than group B. In both groups fasting and postglucose area under the plasma concentration-time curve insulin significantly reduced. The homeostasis model assessment of insulin and insulin sensitivity indexes and total to high-density lipoprotein cholesterol ratio improved only in group A. Conclusions: GH treatment for 6 months after LASGB reduces loss in LBM and appendicular skeletal muscle mass during a standardized program of low-calorie diet and physical exercise program, with improvement of lipid profile and without a deterioration of glucose tolerance.

Original languageEnglish
Pages (from-to)817-826
Number of pages10
JournalJournal of Clinical Endocrinology and Metabolism
Volume94
Issue number3
DOIs
Publication statusPublished - Mar 2009

Fingerprint

Bariatric Surgery
Silicones
Surgery
Growth Hormone
Stomach
Exercise
Skeletal Muscle
Fats
Insulin
Diet
Caloric Restriction
Clinical Protocols
Postoperative Period
HDL Cholesterol
Nutrition
Insulin Resistance
Weight Loss
Fasting
Body Mass Index
Homeostasis

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

Cite this

Growth hormone treatment prevents loss of lean mass after bariatric surgery in morbidly obese Patients : Results of a pilot, open, prospective, randomized, controlled study. / Savastano, Silvia; Di Somma, Carolina; Angrisani, Luigi; Orio, Francesco; Longobardi, Salvatore; Lombardi, Gaetano; Colao, Annamaria.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 94, No. 3, 03.2009, p. 817-826.

Research output: Contribution to journalArticle

Savastano, Silvia ; Di Somma, Carolina ; Angrisani, Luigi ; Orio, Francesco ; Longobardi, Salvatore ; Lombardi, Gaetano ; Colao, Annamaria. / Growth hormone treatment prevents loss of lean mass after bariatric surgery in morbidly obese Patients : Results of a pilot, open, prospective, randomized, controlled study. In: Journal of Clinical Endocrinology and Metabolism. 2009 ; Vol. 94, No. 3. pp. 817-826.
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abstract = "Context: The loss of lean body mass (LBM) negatively influences the outcome in bariatric surgery. Impaired GH secretion is frequent in obese patients. Objective: Our objective was to investigate if GH treatment prevents LBM loss in the early postoperative period. Design: This was an open, prospective, randomized, and controlled study. Patients: A total of 24 women (body mass index: 44.4 ± 7.6 kg/m2, aged 36.8 ± 11.7yr) undergoing laparoscopic-adjustable silicone gastric banding (LASGB) and with GH deficiency after LASGB was included in the study. Treatment Protocol: Group A (n = 12) included a standardized diet regimen and exercise program plus recombinant human GH (0.5 ± 0.13 mg every day), and group B (n = 12) included a standardized diet regimen and exercise program. The follow-up duration was 6 months. Results: The excess of body weight loss did not differ between groups A and B after 3 and 6 months. At 3 months, LBM loss was lower (P <0.0001) and fat mass (FM) loss was higher (P = 0.02) in group A than group B. At 3 and 6 months, appendicular skeletal muscle mass loss was lower (P = 0.000) in group A than group B. At 3 (P = 0.0003 and 0.0005, respectively) and 6 months (P <0.0001 and 0.0002, respectively), the percent changes of FM and lean body mass were significantly higher in group A than group B. In both groups fasting and postglucose area under the plasma concentration-time curve insulin significantly reduced. The homeostasis model assessment of insulin and insulin sensitivity indexes and total to high-density lipoprotein cholesterol ratio improved only in group A. Conclusions: GH treatment for 6 months after LASGB reduces loss in LBM and appendicular skeletal muscle mass during a standardized program of low-calorie diet and physical exercise program, with improvement of lipid profile and without a deterioration of glucose tolerance.",
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AU - Orio, Francesco

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