Growth Hormone-releasing Hormone Could Help Build Bone in HIV Patients

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By Anne Harding

Growth hormone-releasing hormone (GHRH) can increase markers of bone turnover in HIV-infected men with lipodystrophy, according to study results in the April issue of The Journal of Clinical Endocrinology & Metabolism.

Reduction in bone density has been tied to truncal and visceral adiposity (fat accumulation) in HIV patients with lipodystrophy, who also show reduced growth hormone levels, Dr. Steven Grinspoon of Harvard Medical School and colleagues note.

"The more abdominal fat, the lower their bone density, and also the lower their growth hormone. We're wondering whether increased truncal adiposity connects many of these observations," Dr. Grinspoon told Reuters Health.

He and his colleagues had previously shown that GHRH therapy could reduce abdominal and visceral adiposity while increasing IGF-1. They conducted the current study to determine if three months of GHRH therapy might have an effect on markers of bone turnover.

A group of 31 males with HIV and abdominal fat accumulation were randomized to1 mg of GHRH subcutaneously twice daily or placebo for 12 weeks.

Bone scans found 32% of the men had osteopenia, while 3% had osteoporosis. "I think it's a fairly common problem, although it's not generally severe," Dr. Grinspoon said. "Nonetheless it's important in that it's a group of people who are fairly young. To have low bone density at a young age is a problem."

While the study was too short to determine if the therapy had any effect on bone density, it did produce increases in markers of bone resorption and formation compared to placebo, the researchers report.

C-terminal telopeptide increased, while N-terminal telopeptide rose but not significantly. N-terminal propeptide of type1 procollagen rose significantly, while osteocalcin showed a tendency to increase.

"With growth hormone releasing hormone at this dose we achieved a physiological increase in growth hormone, so this was really without side effects," Dr. Grinspoon noted.

Studies are now ongoing to determine the effect of GHRH on bone density in this group of patients, he added, and the appropriate duration of therapy.

05/23/05

J Clin Endocrinol Metab 2005;90:2154-2160.