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Growth Hormone as a Determinant of Weight Regulation

Growth Hormone as a Determinant of Weight Regulation.

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00355784
Enrollment
24
Registered
2006-07-25
Start date
2005-09-30
Completion date
2015-12-31
Last updated
2016-01-01

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Obesity

Keywords

growth hormone, overfeeding, energy expenditure, protein metabolism, lipid metabolism

Brief summary

With the alarming increase in the prevalence of obesity, identifying factors that predispose individuals to weight-gain is of critical importance. Even when caloric intake and physical activity levels are well controlled, susceptibility for weight-gain is heterogeneous. Basal metabolic rate (BMR) represents the largest portion of daily energy expenditure in normal adults, and as such, variability in BMR among individuals can be a major factor in determining the susceptibility for gaining weight. However, factors responsible for this variability in BMR and resistance to weight-gain remain unclear. Our preliminary data indicate that high-normal growth hormone (GH) concentration is associated with resistance to weight-gain in rats when overfed and greater weight-loss in humans when underfed. In addition, the investigators have found that the pulsatility of GH secretion has profound effects on several metabolic processes. Therefore, together these findings suggest that endogenous GH secretion is associated with body weight regulation, and the pulsatility (peak amplitude) of GH secretion, rather than the absolute GH concentration, per se, may be responsible for this effect. Because GH influences many of the key metabolic processes that contribute to BMR (e.g.; protein synthesis, proteolysis, substrate cycling), the investigators anticipate that the resistance to weight-gain in persons with elevated GH concentrations will be associated with an increase in BMR due to acceleration of some or all of these processes. Our overall hypothesis is that increased GH secretion can protect against weight-gain due to an augmentation of major metabolic processes that contribute to BMR. Identifying factors responsible for predisposing individuals to weight-gain will lead to establishing improved methods for reducing the prevalence of obesity.

Detailed description

The susceptibility to gain weight is highly variable even when caloric intake and physical activity are well controlled. Because basal metabolic rate (BMR) represents \ 70% of total daily energy expenditure (TDEE), even a small difference in BMR can affect daily energy balance, thereby increasing the susceptibility for gaining weight. Our preliminary data indicate that high-normal growth hormone (GH) secretion is associated with resistance to weight-gain in rats when overfed and greater weight-loss in humans when underfed. Given that GH influences many of the key metabolic processes that contribute to BMR, the investigators hypothesize that persons with high-normal GH will be resistant to weight-gain because of a high BMR, resulting from accelerated rates of these processes. The investigators will measure basal 24h GH secretion and BMR in 106 non-obese men and women. The investigators will also measure protein synthesis, proteolysis, triglyceride/fatty acid cycling (all measured using stable isotope tracer methods) to determine the relationships among these processes, BMR, and GH \[Specific Aim 1\]. Subjects identified as having low-normal (\<1.5 ug/L) and high-normal (\>3 ug/L) 24h GH will then be admitted to the hospital for a 2 wk overfeeding protocol (\ 2000 kcal/d \>TDEE - with restricted physical activity), immediately followed by a 4 wk caloric restriction protocol (\ 750 kcal/d \<TDEE) to compare changes in weight, body composition and intra-abdominal adiposity between these groups that differ markedly in their GH secretion (GH measured before the diet) \[Specific Aim 2\]. A subset of subjects with low-normal GH will receive intravenous GH throughout the 2 wk overfeeding period at either: 1. a constant rate or 2. as a pulsatile infusion (to mimic endogenous secretion). BMR will be assessed daily and protein synthesis, proteolysis, and triglyceride/fatty acid cycling will be measured at the end of the 2 wks \[Specific Aim 3\]. The investigators anticipate that a higher GH pulsatility (peak amplitude), rather than elevated GH concentration, per se, will increase protein synthesis, proteolysis, and triglyceride/fatty acid cycling with a resultant increase in BMR and resistance to weight-gain. Identifying factors responsible for predisposing individuals to weight-gain will help combat the alarming rise in the prevalence of obesity.

Interventions

overfeeding 2000kcals/day above energy requirements for 14d

DRUGgrowth hormone treatment

growth hormone administrated for 2 weeks (dose = 1.0 mg/m2/d)

Sponsors

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
CollaboratorNIH
University of Michigan
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to 35 Years
Healthy volunteers
Yes

Inclusion criteria

Age = 21-35 years Weight stable (\< ± 5 pound over past 6 months) Premenopausal (women only) Body mass index 18 - 26 kg/m2 Must be willing to be randomized to receive GH infusion during 2 week Michigan Clinical Research Unit (MCRU) visit

Exclusion criteria

* Evidence of metabolic or cardiovascular disease Pregnancy (women only) Hyperlipidemia (fasting plasma triglyceride concentration \> 150 mg/dl) Hematocrit \< 34% Liver Function test abnormalities participating in a regular exercise program (\> 2 h/week) taking any prescription medication (except birth control)

Design outcomes

Primary

MeasureTime frameDescription
2 Week Skeletal Muscle Protein Synthesis2 weeksafter an overnight fast
Changes in Fat Mass2 weeks
Changes in Fat-free Mass2 weeks
Baseline Whole Body Protein TurnoverbaselineWhole body proteolytic rate (Leucine Ra)
Baseline Skeletal Muscle Protein Synthesisbaselineafter an overnight fast
Lipolytic Rate2 weeks
Whole Body Protein Turnover After 2 Week Intervention2 weekswhole body proteolytic rate (leucine Ra)
24 Hour Average Plasma Growth Hormone Concentration2 weeks
Changes in Body Weight2 weeks

Countries

United States

Participant flow

Recruitment details

All subjects were admitted to the Michigan Clinical Research Unit at the University of Michigan Hospital. Subjects were recruited from February 2006-February 2011.

Pre-assignment details

Before the overeating intervention all subjects were admitted to the hospital for a 2-day experiment to assess their plasma growth hormone and insulin profiles.

Participants by arm

ArmCount
Control
9 non-obese (initial body mass index 23.5 +/- 0.3 kg/m2), weight stable, relatively sedentary (physical activity \</- 2h/week), healthy adults not taking any medications were admitted to the hospital for 2 weeks during which time they ate \ 4000 kcal/day and their plasma growth hormone concentration was allowed to decline naturally.
9
Growth Hormone Treatment
8 non-obese (initial body mass index 23.5 +/- 0.3 kg/m2), weight stable, relatively sedentary (physical activity \</- 2h/week), healthy adults not taking any medications were admitted to the hospital for 2 weeks during which time they ate \ 4000 kcal/day and received exogenous growth hormone treatment administered in 4 daily injections to mimic physiological growth hormone secretion throughout the 2-week overeating period.
8
High Growth Hormone Treatment
5 non-obese (initial body mass index 23.5 +/- 0.3 kg/m2), weight stable, relatively sedentary (physical activity \</- 2h/week), healthy adults not taking any medications were admitted to the hospital for 2 weeks during which time they ate \ 4000 kcal/day and received a relatively high daily dose of growth hormone.
5
Total22

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Overall StudyWithdrawal by Subject002

Baseline characteristics

CharacteristicGrowth Hormone TreatmentHigh Growth Hormone TreatmentControlTotal
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
0 Participants0 Participants0 Participants0 Participants
Age, Categorical
Between 18 and 65 years
8 Participants5 Participants9 Participants22 Participants
Age, Continuous23.1 years
STANDARD_DEVIATION 1
24.9 years
STANDARD_DEVIATION 1.9
24.5 years
STANDARD_DEVIATION 1.2
24.4 years
STANDARD_DEVIATION 0.8
Region of Enrollment
United States
8 participants5 participants9 participants22 participants
Sex: Female, Male
Female
1 Participants1 Participants2 Participants4 Participants
Sex: Female, Male
Male
7 Participants4 Participants7 Participants18 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —
other
Total, other adverse events
1 / 90 / 80 / 5
serious
Total, serious adverse events
0 / 90 / 80 / 5

Outcome results

Primary

24 Hour Average Plasma Growth Hormone Concentration

Time frame: 2 weeks

Population: per protocol

ArmMeasureValue (MEAN)Dispersion
Control (CON)24 Hour Average Plasma Growth Hormone Concentration0.4 ng/mLStandard Error 0.1
Growth Hormone Treatment (GHT)24 Hour Average Plasma Growth Hormone Concentration1.2 ng/mLStandard Error 0.1
High Growth Hormone Treatment (High-GHT)24 Hour Average Plasma Growth Hormone Concentration4.1 ng/mLStandard Error 0.3
Primary

2 Week Skeletal Muscle Protein Synthesis

after an overnight fast

Time frame: 2 weeks

Population: per protocol

ArmMeasureValue (MEAN)Dispersion
Control (CON)2 Week Skeletal Muscle Protein Synthesis0.063 skeletal muscle protein%/hourStandard Error 0.015
Growth Hormone Treatment (GHT)2 Week Skeletal Muscle Protein Synthesis0.062 skeletal muscle protein%/hourStandard Error 0.018
High Growth Hormone Treatment (High-GHT)2 Week Skeletal Muscle Protein Synthesis0.082 skeletal muscle protein%/hourStandard Error 0.011
Primary

Baseline Skeletal Muscle Protein Synthesis

after an overnight fast

Time frame: baseline

Population: per protocol

ArmMeasureValue (MEAN)Dispersion
Control (CON)Baseline Skeletal Muscle Protein Synthesis0.043 skeletal muscle protein%/hourStandard Error 0.009
Growth Hormone Treatment (GHT)Baseline Skeletal Muscle Protein Synthesis0.047 skeletal muscle protein%/hourStandard Error 0.011
High Growth Hormone Treatment (High-GHT)Baseline Skeletal Muscle Protein Synthesis0.033 skeletal muscle protein%/hourStandard Error 0.006
Primary

Baseline Whole Body Protein Turnover

Whole body proteolytic rate (Leucine Ra)

Time frame: baseline

Population: per protocol

ArmMeasureValue (MEAN)Dispersion
Control (CON)Baseline Whole Body Protein Turnover2.1 μmol/kg fat free mass/min)Standard Error 0.1
Growth Hormone Treatment (GHT)Baseline Whole Body Protein Turnover1.9 μmol/kg fat free mass/min)Standard Error 0.1
High Growth Hormone Treatment (High-GHT)Baseline Whole Body Protein Turnover1.6 μmol/kg fat free mass/min)Standard Error 0.1
Primary

Changes in Body Weight

Time frame: 2 weeks

Population: per protocol

ArmMeasureValue (MEAN)Dispersion
Control (CON)Changes in Body Weight2.4 kgStandard Error 0.6
Growth Hormone Treatment (GHT)Changes in Body Weight3.6 kgStandard Error 0.6
High Growth Hormone Treatment (High-GHT)Changes in Body Weight3.1 kgStandard Error 0.7
Primary

Changes in Fat-free Mass

Time frame: 2 weeks

ArmMeasureValue (MEAN)Dispersion
Control (CON)Changes in Fat-free Mass0.7 kgStandard Error 0.3
Growth Hormone Treatment (GHT)Changes in Fat-free Mass2.2 kgStandard Error 0.3
High Growth Hormone Treatment (High-GHT)Changes in Fat-free Mass2.3 kgStandard Error 0.6
Primary

Changes in Fat Mass

Time frame: 2 weeks

ArmMeasureValue (MEAN)Dispersion
Control (CON)Changes in Fat Mass1.6 kgStandard Error 0.3
Growth Hormone Treatment (GHT)Changes in Fat Mass1.7 kgStandard Error 0.2
High Growth Hormone Treatment (High-GHT)Changes in Fat Mass1.1 kgStandard Error 0.3
Primary

Lipolytic Rate

Time frame: 2 weeks

Population: per protocol

ArmMeasureValue (MEAN)Dispersion
Control (CON)Lipolytic Rate180 µmol/minStandard Error 19
Growth Hormone Treatment (GHT)Lipolytic Rate200 µmol/minStandard Error 20
High Growth Hormone Treatment (High-GHT)Lipolytic Rate195 µmol/minStandard Error 25
Primary

Whole Body Protein Turnover After 2 Week Intervention

whole body proteolytic rate (leucine Ra)

Time frame: 2 weeks

Population: per protocol

ArmMeasureValue (MEAN)Dispersion
Control (CON)Whole Body Protein Turnover After 2 Week Intervention2.8 µmol/kg fat free mass/minStandard Error 0.2
Growth Hormone Treatment (GHT)Whole Body Protein Turnover After 2 Week Intervention2.3 µmol/kg fat free mass/minStandard Error 0.1
High Growth Hormone Treatment (High-GHT)Whole Body Protein Turnover After 2 Week Intervention1.9 µmol/kg fat free mass/minStandard Error 0.1

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026