Growth Hormone Helps Prevent Lean Mass Loss after Bariatric Surgery

Loss of lean body mass can have a negative impact on the outcome of bariatric surgery, and impaired secretion of growth hormone happens frequently in obese patients. Dr. Silvia Savastano and co-workers at the University of Naples recently found that treatment with human growth hormone (hGH) for six months after laparoscopic adjustable silicone gastric banding (LASGB) reduced loss of lean body mass and skeletal muscle mass in a group of 24 women (J Clin Endocrinol Metab 2009; 94:817 ).

In an open, prospective, randomized, controlled study, 24 women with a mean body mass index (BMI) of 44.4 kg/m2 and who had hGH deficiency were included in the study. The participants had to have functionally severe hGH deficiency (peak of 4.2 mcg/L or less after an arginine-hGH-releasing test. One group (Group A, 12 patients) received a standardized diet regimen and exercise program plus recombinant hGH (0.5 mg per day). A second group (Group B, 12 patients) was given a standardized diet regimen and exercise program, and no hGH supplements. All the participants in the study were followed for six months.

Follow-up

At three months, loss of LBM was lower and fat mass loss was significantly higher in the group treated with hGH than in the group treated with diet and exercise only. Lipid profiles improved in both groups and there was no deterioration in glucose tolerance. Instead, insulin resistance and sensitivity indexes improved only in patients treated with hGH.

Six months after surgery, weight loss did not differ between the two groups. None of the patients had postoperative complications and none of the patients reported exercising regularly. BMI was significantly reduced in both groups of patients. The total to HDL cholesterol ratio was significantly reduced only in Group A patients.

The authors note that these findings could open new frontiers for use of hGH therapy to manage morbidly obese patients. They also caution that considering the costs of recombinant hGH hormone therapy, a careful cost-benefit analysis is required for all patients considering growth hormone replacement treatment.

It is worth mentioning that there are serious long-term risks associated with hGH supplementation. This is one reason that such supplements are considered unsafe for most adults. According to the National Institutes of Health, among the risks are progression of cancers, fluid buildup, and diabetes.