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GH and Cardiovascular Risk Factors

Phase 4
Completed
Conditions
Growth Hormone Deficiency
Cardiovascular Diseases
Metabolic Syndrome
Cognition
Physical Activity
Interventions
Drug: Change in daily dosage of Growth Hormone
Registration Number
NCT01877512
Lead Sponsor
Amsterdam UMC, location VUmc
Brief Summary

Rationale: Abnormally low and high levels of insulin-like growth factor-I (IGF-I) are both associated with increased metabolic risk. Since (U-shaped) associations of IGF-I, within the normal range, have also been found with cardiovascular risk factors and disease in the general population, it would be interesting to investigate if this association can also be found in growth hormone deficient (GHD) adults treated with Growth Hormone (GH). This could be of interest for endocrinologists prescribing GH in clinical practice because strict dosing may become even more important. Next to that, scientific evidence for clinical practice is wanted.

Objective: Next to cardiovascular risk factors (main objectives: body composition and lipid profile; secondary objectives: remainder) we investigate the effect on glucose metabolism, physical performance, and neuropsychological functioning of different levels of IGF-I in GH treated GHD men and women.

Study design: Open-label randomized trial.

Study population: At least 32 subjects, both childhood as adult onset GHD men and women, receiving GH treatment for at least one year, with an age between 20 and 65 years.

Intervention: At entry subjects are already receiving GH treatment according to general clinical practice, and are expected to demonstrate an IGF-I concentration of 0 - 1 SD score (SDS) (normal dose). The group of men and group of women will be randomized to receive either a decrease of their regular dose of GH treatment (IGF-I target level of -2 - -1 SDS) (low dose), or an increase of their regular dose, (IGF-I target level of 1 - 2 SDS) (high dose) for at least 24 weeks.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
32
Inclusion Criteria
  • Ongoing surveillance at our centre (VUmc)
  • Stable substitution therapy for other pituitary hormone deficiencies
Exclusion Criteria
  • Subjects with a craniopharyngioma as cause of their GHD or pituitary deficiencies
  • Contraindications for the use of GH treatment
  • (Receiving treatment for) malignant disease (in the past)
  • Cardiovascular event less than one year prior to inclusion
  • Participation in other studies
  • Subjects, who in the opinion of the investigator, are unsuitable in any other way to participate in this study

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Low dose Growth HormoneChange in daily dosage of Growth HormoneHalve of the group of men and group of women will receive a decrease of their regular dose of Growth Hormone treatment, with the IGF-I target level of -2 - -1 SD score (low dose=LD).
High dose Growth HormoneChange in daily dosage of Growth HormoneHalve of the group of men and group of women will receive an increase of their regular dose of Growth Hormone treatment, with the IGF-I target level of 1 - 2 SD score (high dose=HD).
Primary Outcome Measures
NameTimeMethod
Change in cardiovascular risk (body composition and lipid profile)24 weeks
Secondary Outcome Measures
NameTimeMethod
Change in cardiovascular risk (inflammatory markers, vascular stiffness, endothelial function, presence of the metabolic syndrome)24 weeks
Change in physical performance (muscle strength, physical activity)24 weeks
Change in glucose metabolism (fasting and 2hr postprandial glucose, insulin resistance)24 weeks
Change in neuropsychological functioning (QoL, cognition, mood)24 weeks

Trial Locations

Locations (1)

VU University Medical Center

🇳🇱

Amsterdam, PO Box 7057, Netherlands

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