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43 GROWTH HORMONE SECRETION AMONG HIV-INFECTED PATIENTS: EFFECTS OF GENDER, RACE, AND FAT DISTRIBUTION.
  1. P. Koutkia,
  2. K. Eaton,
  3. S. M. You,
  4. J. Breu,
  5. S. K. Grinspoon
  1. Massachusetts General Hospital Program in Nutritional Metabolism and Neuroendocrine Unit, Harvard Medical School, Boston, MA; *General Clinical Research Center, Massachusetts Institute of Technology, Cambridge, MA

Abstract

Objective To determine the effects of gender, race, and fat redistribution on growth hormone (GH) secretory patterns in HIV-infected patients.

Design We investigated GH responses to GHRH + arginine stimulation testing in HIV-infected subjects with fat redistribution, comparing HIV-infected males (n = 139) and females (n = 25) to non-HIV-infected male (n = 25) and female (n = 26) control subjects similar in age, BMI, and race.

Methods A standard growth hormone releasing hormone (GHRH) GHRH + arginine stimulation test [GHRH 1 μg/kg and arginine (0.5 g/kg, maximum dose 30 g)] was performed, and fat redistribution was assessed by anthropometric measurements.

Results Waist to hip ratio (WHR) was markedly different between male HIV-infected and control subjects and between female HIV-infected and control subjects (0.99 ± 0.01 vs 0.91 ± 0.01, p < .0001 for males and 0.94 ± 0.02 vs 0.85 ± 0.01, p = .0001 for females, HIV vs controls, respectively, in each comparison). HIV-infected women had significantly higher peak GH in response to GHRH + arginine (36.4 ± 7.3 vs 18.9 ± 2.0 ng/mL, p = .003) and GH area under the curve (AUC) (2,678.8 ± 593.3 vs 1,283.8 ± 133.4 mg/dL*min, p < .001) compared to HIV-infected men. Among men, a cutoff of 7.5 ng/mL for peak GH response on the GHRH + arginine test achieved good specificity and sensitivity and optimally separated the HIV and control groups (eg, the failure rates were 37% vs 8%, p = .004, respectively). Among women, no specific cutoff could be determined to separate the HIV and control subjects. Non-Caucasians demonstrated a higher GH AUC response compared to Caucasians among the HIV-infected male subjects. In stepwise regression modeling WHR was most significantly related to peak GH in response to GHRH + arginine in HIV-infected men.

Conclusions HIV-infected men with fat redistribution have significantly reduced GH peak responses and increased failure rates to standardized GH stimulation testing in comparison to healthy male control subjects and to HIV-infected women of similar age and BMI. GH secretion is related to gender and race in HIV-infected patients.

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