A weekly administered sustained-release growth hormone reduces visceral fat and waist circumference in abdominal obesity

The Association Between Preoperative Insulin-Like Growth Factor 1 Levels and the Total Body Weight Loss in Women Post Laparoscopic Sleeve Gastrectomy

BACKGROUND

Despite the well-described optimal initial clinical response of sleeve gastrectomy (SG) in the treatment of obesity, some patients do not achieve optimal initial clinical response. Insulin-like growth factor-1 (IGF-1) has currently shown an association with post-bariatric surgery weight loss. This study aimed to assess the IGF-1 levels in female patients with obesity, the change after surgery, and their association with the metabolic profile and weight loss after surgery.

PATIENTS AND METHODS

This was a prospective study that was conducted on adult female patients who were recruited for SG. The patients underwent clinical and laboratory investigations that included the IGF-1 measurement. At the 1-year follow-up, the same clinical and laboratory measures were repeated.

RESULTS

This study included 100 female patients. At the 1-year follow-up, there was a statistically significant reduction in body mass index (BMI) (p < 0.001), fasting HbA1C levels (p < 0.001), and triglycerides (p < 0.001), as well as a statistically significant increase in HDL (p < 0.001) and IGF-1 (p < 0.001). Multiple regression analysis revealed that, among the patients baseline characteristics, the significant predictors for the percentage of total weight loss (%TWL) were the patients' BMI (p < 0.001) and IGF-1 levels (p < 0.001). The ROC curve showed that an IGF1 cutoff value of ≤ 23 ng/ml detected suboptimal initial clinical response, with a sensitivity of 95.35% and a specificity of 100%.

CONCLUSION

This study underscores the significant impact of SG on weight loss and metabolic improvements in female patients. Baseline IGF-1 levels emerged as a crucial predictor of optimal initial clinical response.

Inhibition of prolactin promotes secondary skin follicle activation in cashmere goats

The aim of this study was to investigate the involvement of prolactin (PRL) on development of secondary skin follicles in cashmere goats. Goats were randomly assigned to either a bromocriptine treatment or control group. Samples of cashmere fiber, blood, and skin were collected from all goats after 1 mo. The results indicated that the length, growth rate, and diameter of fibers were not influenced (P > 0.05) by the inhibition of PRL resulting from the treatment with bromocriptine. There was a tendency for increases in total follicle number, primary and secondary follicle numbers, and in the ratio of secondary to primary follicles following treatment with bromocriptine, but these differences were not significant (P > 0.05). The percentage of active secondary follicles in anagen was increased (P < 0.05) in the bromocriptine-treated goats, but there was no effect of treatment on the percentage of active primary follicles. Bromocriptine decreased (P < 0.05) circulating concentrations of PRL and Insulin-like growth factor 1 (IGF1) and increased (P < 0.05) those of melatonin (MT), but there was no effect of this treatment on the serum concentrations of cortisol, growth hormone, tetraiodothyronine, and triiodothyronine. In bromocriptine-treated goats, mRNA expressions of PRL and MT membrane receptor 1a (MTNR1a) were decreased (P < 0.05) and mRNA expression of MT nuclear receptor (RORα) was increased (P < 0.05), but there was no effect of the treatment on expression of long PRL receptor, short PRL receptor, MT membrane receptor 1b and IGF1. It is concluded that inhibition of PRL promotes secondary hair follicle development in the anagen phase, possibly by downregulating MTNR1a and up-regulating RORα gene expression in the skin.

Low serum insulin-like growth factor-1 level is a predictor of low total weight loss percentage after sleeve gastrectomy

BACKGROUND

Obesity is a leading cause of metabolic disorders and mortality. Laparoscopic sleeve gastrectomy (LSG) confers beneficial effects not only on weight but also on metabolic disorder development. However, some patients show insufficient weight loss after LSG. A total weight loss percentage (%TWL) <20% after LSG is defined as insufficient. The prediction of patients with insufficient weight loss after LSG before the procedure is performed may prove helpful.

OBJECTIVES

To determine predictors of %TWL after LSG.

SETTING

Longitudinal study in a university hospital.

METHODS

We retrospectively reviewed 90 obese patients who underwent LSG and were followed up for 12 months thereafter. We analyzed the relationship between %TWL and preoperative clinical parameters, such as age, sex, body mass index, lipid and glucose metabolism, and some hormones. Patients were divided into 2 groups, %TWL <20% and 20% ≤ %TWL. Multiple regression model and logistic regression models were performed.

RESULTS

LSG led to significant improvements in weight, liver, and kidney function, and lipid and glucose metabolism. The serum insulin-like growth factor-1 (IGF-1) level was significantly lower in patients with %TWL <20%. Sex, diabetes presence, body mass index, and IGF-1 were independent predictors of %TWL. Receiver operating characteristic curve analysis showed that the cutoff value of IGF-1 for %TWL <20% was 100.0ng/mL. Male sex, diabetes presence, lower preoperative BMI, and IGF-1 values were independently associated with lower %TWL (%TWL <20%).

CONCLUSIONS

Serum IGF-1 can be used to screen for patients at risk of low %TWL after LSG.

Diagnosis and Treatment of Growth Hormone Deficiency: A Position Statement from Korean Endocrine Society and Korean Society of Pediatric Endocrinology

Growth hormone (GH) deficiency is caused by congenital or acquired causes and occurs in childhood or adulthood. GH replacement therapy brings benefits to body composition, exercise capacity, skeletal health, cardiovascular outcomes, and quality of life. Before initiating GH replacement, GH deficiency should be confirmed through proper stimulation tests, and in cases with proven genetic causes or structural lesions, repeated GH stimulation testing is not necessary. The dosing regimen of GH replacement therapy should be individualized, with the goal of minimizing side effects and maximizing clinical improvements. The Korean Endocrine Society and the Korean Society of Pediatric Endocrinology have developed a position statement on the diagnosis and treatment of GH deficiency. This position statement is based on a systematic review of evidence and expert opinions.

Effects of high fat diet induced obesity on peripheral nerve regeneration and levels of GAP 43 and TGF-β in rats

The increasing frequency of obesity is important because of its accompanying related health problems. The effects of obesity on peripheral nerves have not been elucidated. We investigated the effects of obesity on sciatic nerve regeneration using electrophysiology, stereology, immunohistochemistry, histopathology and functional tests. We used control, obese, control injured and obese injured groups of rats. Electrophysiological results showed that nerve conduction velocity and EMG were same in the experimental groups, but the amplitude of the compound action potential of the control group was significantly higher than that of the obese group. Examination of the nerves showed that the control and obese groups had both larger axon diameters and thicker myelin sheaths. The number of myelinated axons was decreased in both of the injured groups. Axon diameters and myelin sheath thicknesses of the control injured group were significantly greater those of the obese injured group. There were no significant differences in functional tests among the groups. Although growth associated protein 43 immunostaining in the control injured group was significantly greater than that of the obese injured group, no significant difference was observed between the control and obese groups. There was no significant difference in immunohistochemical staining for transforming growth factor beta 3 between the control injured and obese injured groups. Our results suggest that obesity may affect peripheral nerve regeneration negatively after crush injury.

Effects of growth hormone withdrawal in obese premenopausal women

OBJECTIVE

We previously reported improved body composition and cardiovascular risk markers plus a small decrease in glucose tolerance with GH administration vs placebo for 6 months to abdominally obese premenopausal women. The objective of this study was to determine whether the effects of GH treatment on cardiovascular risk markers, body composition and glucose tolerance in obese women persist 6 months after GH withdrawal.

DESIGN AND PATIENTS

Fifty abdominally obese premenopausal women completed a trial of rhGH vs placebo for 6 months; thirty-nine women completed a subsequent 6-month withdrawal observation period.

MEASUREMENTS

IGF-I, body composition by CT, (1) H-MRS and DXA, serum cardiovascular risk markers, oral glucose tolerance test (OGTT).

RESULTS

IGF-I standard deviation scores (SDS) within the GH group were -1.7 ± 0.1 (pretreatment),-0.1 ± 0.3 (after 6 months of GH) and -1.7 ± 0.1 (6 months post-GH withdrawal). Six months after GH withdrawal, total abdominal and subcutaneous adipose tissue, total fat, trunk fat, trunk/extremity fat, hsCRP, apoB, LDL, and tPA were higher than at the 6-month (GH discontinuation) timepoint (P ≤ 0.05). All body composition and cardiovascular risk markers that had improved with GH returned to baseline levels by 6 months after GH discontinuation, as did fasting and 2-h OGTT glucose levels.

CONCLUSION

The effects of GH administration to abdominally obese premenopausal women have a short time-course. The beneficial effects on body composition and cardiovascular risk markers, and the side effect of altered glucose tolerance returned to pretreatment levels after GH withdrawal. There was no suppression of endogenous IGF-I levels, which returned to baseline after GH withdrawal.