Effects of recombinant human growth hormone therapy in obesity in adults: A metaanalysis

Abstract

Objective: To conduct a metaanalysis of human studies examining the efficacy and safety of recombinant human GH (rhGH) as therapy for obesity in adults. Design: A thorough search of the literature (including MEDLINE, EMBASE, and the Cochrane Register) was performed for pertinent studies, which were analyzed and subsequently synthesized in a comprehensive meta-analysis. Results: Administration of rhGH led to significant changes in body composition [weighted mean difference (95% confidence interval)], including fat mass [-0.9 kg (-1.3 to -0.4)], percent body fat [-1%(-1.3 to -0.7)], lean body mass [1.8 kg (0.6-2.9)], visceral adipose area [-22.8 cm2 (-39.8 to -5.7)], and lipid profile, including total cholesterol [-7 mg/dl (-11 to -3)] and low-density lipoprotein-cholesterol [-9 mg/dl (-13 to -5)]. There were increases in fasting plasma glucose [3 mg/dl (1-6)] and insulin [1.9 μU/ml (0.2-3.7)]. The latter finding was found only in shorter-term studies. Adverse effects included [odds ratio (95% confidence interval)] arthralgias [6 (1.9-18.6)], peripheral edema [5 (2.4-10.5)], and paresthesias [6.5 (1.5-27.3)]. Conclusions: Our metaanalysis suggests that rhGH therapy leads to decrease in visceral adiposity and increase in lean body mass as well as beneficial changes in lipid profile in obese adults, without inducing weight loss. Administration of rhGH was associated with increases in fasting plasma glucose and insulinemia. Because the rhGH doses used in many studies were supraphysiological, future studies of longer duration, using carefully titrated rhGH protocols, will be needed to fully establish the effects of rhGH therapy in obesity, including effects on cardiovascular morbidity and mortality. Copyright © 2009 by The Endocrine Society.