Document Detail


Impact of GH replacement therapy on sleep in adult patients with GH deficiency of pituitary origin.
MedLine Citation:
PMID:  23447518     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We previously reported that adult patients with GH deficiency (GHD) due to a confirmed or likely pituitary defect, compared with healthy controls individually matched for age, gender, and BMI, have more slow-wave sleep (SWS) and higher delta activity (a marker of SWS intensity). Here, we examined the impact of recombinant human GH (rhGH) therapy, compared with placebo, on objective sleep quality in a subset of patients from the same cohort.
DESIGN: Single-blind, randomized, crossover design study.
METHODS: Fourteen patients with untreated GHD of confirmed or likely pituitary origin, aged 22-74 years, participated in the study. Patients with associated hormonal deficiencies were on appropriate replacement therapy. Polygraphic sleep recordings, with bedtimes individually tailored to habitual sleep times, were performed after 4 months on rhGH or placebo.
RESULTS: Valid data were obtained in 13 patients. At the end of the rhGH treatment period, patients had a shorter sleep period time than at the end of the placebo period (479±11 vs 431±19 min respectively; P=0.005), primarily due to an earlier wake-up time, and a decrease in the intensity of SWS (delta activity) (559±125 vs 794±219 μV(2) respectively; P=0.048).
CONCLUSIONS: Four months of rhGH replacement therapy partly reversed sleep disturbances previously observed in untreated patients. The decrease in delta activity associated with rhGH treatment adds further evidence to the hypothesis that the excess of high-intensity SWS observed in untreated pituitary GHD patients is likely to result from overactivity of the hypothalamic GHRH system due to the lack of negative feedback inhibition by GH.
Authors:
Lisa L Morselli; Arlet Nedeltcheva; Rachel Leproult; Karine Spiegel; Enio Martino; Jean-Jacques Legros; Roy E Weiss; Jean Mockel; Eve Van Cauter; Georges Copinschi
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural     Date:  2013-04-15
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  168     ISSN:  1479-683X     ISO Abbreviation:  Eur. J. Endocrinol.     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-04-16     Completed Date:  2013-06-06     Revised Date:  2013-12-03    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  England    
Other Details:
Languages:  eng     Pagination:  763-70     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Brain Waves / drug effects*
Cerebral Cortex / drug effects*
Cross-Over Studies
Female
Hormone Replacement Therapy*
Human Growth Hormone / deficiency,  pharmacology,  therapeutic use*
Humans
Hypopituitarism / drug therapy*
Male
Middle Aged
Polysomnography
Single-Blind Method
Sleep / drug effects*
Treatment Outcome
Grant Support
ID/Acronym/Agency:
M01 RR-00055/RR/NCRR NIH HHS; M01 RR000055/RR/NCRR NIH HHS; P01 AG-11412/AG/NIA NIH HHS; P01 AG011412/AG/NIA NIH HHS; T32 HL-07909/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
12629-01-5/Human Growth Hormone
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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