Glucose homeostasis does not appear to be affected by 4 years of growth hormone replacement therapy in adults with growth hormone deficiency, study data show.
Matthias M. Weber, MD, department of endocrinology and metabolism, University of Mainz in Germany, and colleagues evaluated data from the NordiNet International Outcome Study on 245 adults with adult-onset GH deficiency (median age at treatment initiation, 50 years; median GH dose, 0.17 mg per day) to determine the effect of 4 years’ GH replacement with somatropin (Norditropin, Novo Nordisk) on glucose homeostasis and factors affecting HbA1c. Baseline and 4-year measurements of HbA1c were included. At year 4, most participants were receiving a standard GH dose (> 0.2 mg per day).
During the first 4 years of GH replacement, seven participants developed diabetes; they were older, receiving a lower GH dose and had higher BMI at baseline compared with participants who did not develop diabetes.
At 4 years, HbA1c remained at the same median baseline level of 5.2%. Mean change in baseline HbA1c was affected by age at treatment start (P = .0094) and BMI (P = .0008). Greater increase in HbA1c was observed in participants with obesity (BMI 30 kg/m2) compared with participants without obesity (normal BMI, 25 kg/m2; P = .0005).
Normal HbA1c was present in 78.4% of participants, 20.8% had impaired glucose tolerance and 0.8% had HbA1c of at least 6.5% at baseline. At 4 years, 84.9% of participants with normal HbA1c at baseline remained at that level, 14% progressed to IGT and 1.1% had HbA1c levels of at least 6.5%.
“These data collected in a real-life clinical setting demonstrate that 4 years of GH replacement therapy in adults with [GH] deficiency had no adverse impact on glucose homeostasis in the majority of patients,” the researchers wrote. “Monitoring glucose parameters is advisable in all patients taking GH replacement, perhaps more frequently in those at higher risk of developing hyperglycemia.” – by Amber Cox
Disclosure: The study was sponsored by Novo Nordisk. Weber reports being a member of the NordiNet IOS International Study Committee.