Circulating Asprosin Declines During 24 Months of Growth Hormone Replacement and Is Associated with IGF-1 and Metabolic Remodeling in Adults with Growth Hormone Deficiency.
In adults with growth hormone deficiency, rhGH therapy was associated with decreased asprosin levels and improvements in body composition over 24 months.
Where it sits
this study against the rest of the hgh (somatropin) corpusSummary and findings
This study measured changes in circulating asprosin (ASP) and its relationship with metabolic parameters in 19 adults with severe growth hormone deficiency (GHD) over 24 months of recombinant human growth hormone (rhGH) therapy. Circulating ASP concentrations significantly declined, while insulin-like growth factor-1 (IGF-1) levels increased. Body fat percentage and fat mass decreased, and lean mass increased after treatment.
Abstract
Adult growth hormone deficiency (GHD) is characterized by insulin resistance, visceral adiposity, and adverse body composition. Asprosin (ASP), an adipokine involved in glucose homeostasis and energy metabolism, has emerged as a potential biomarker of metabolic dysfunction. This study investigated longitudinal changes in circulating ASP and their relationships with metabolic, body composition, and bone parameters during 24 months of recombinant human growth hormone (rhGH) therapy. Nineteen adults with severe GHD were prospectively evaluated before and during rhGH replacement. Serum ASP, insulin-like growth factor-1 (IGF-1), metabolic and lipid parameters were assessed, while body composition and bone indices were determined by dual-energy X-ray absorptiometry. Associations between ASP and clinical variables were analyzed using Spearman's rank correlation. RhGH therapy significantly reduced circulating ASP concentrations at 12 and 24 months, while IGF-1 concentrations increased significantly throughout follow-up. Body fat percentage and fat mass decreased, whereas lean mass increased after 24 months of treatment. Significant changes in bone mineral content and lumbar spine Z-score were also observed after 24 months. ASP was consistently inversely correlated with fasting glucose and developed negative associations with IGF-1 and fat mass during follow-up. Time-dependent associations were also observed with visceral adiposity and lipid parameters, whereas no consistent associations between ASP and skeletal parameters were identified. Long-term rhGH replacement was associated with sustained reductions in circulating ASP concentrations and metabolic remodeling. These findings suggest that ASP may represent a candidate marker of metabolic adaptation during rhGH replacement, although validation in larger prospective cohorts is required.
Background
This paper addresses the relationship between asprosin, a biomarker linked to metabolic dysfunction, and growth hormone replacement therapy in adults with growth hormone deficiency (GHD). Prior knowledge indicated that GHD is associated with insulin resistance and adverse body composition. Understanding the role of asprosin during growth hormone therapy may provide insights into metabolic adaptations.
Methods
The study was a prospective evaluation of 19 adults with severe GHD receiving recombinant human growth hormone therapy over 24 months. Serum asprosin, IGF-1, metabolic and lipid parameters were assessed, and body composition was measured using dual-energy X-ray absorptiometry. Primary outcomes included changes in circulating asprosin and IGF-1 levels, while secondary outcomes involved body composition and bone parameters.
Results
Circulating asprosin concentrations decreased significantly at 12 months and 24 months, n=19. IGF-1 concentrations increased significantly throughout follow-up, n=19. Body fat percentage and fat mass decreased, while lean mass increased after 24 months of treatment, n=19. Significant changes in bone mineral content and lumbar spine Z-score were also observed after 24 months, n=19.
Interpretation
The findings suggest that rhGH therapy leads to significant reductions in asprosin levels and improvements in metabolic parameters, which aligns with previous literature on growth hormone's effects on body composition. However, the clinical significance of these changes remains uncertain, particularly given the small sample size and the need for larger studies to confirm these results. The lack of consistent associations between asprosin and skeletal parameters also limits the conclusions that can be drawn.
Key findings
- Circulating asprosin concentrations decreased significantly at 12 months and 24 months, n=19.
- IGF-1 concentrations increased significantly throughout follow-up, n=19.
- Body fat percentage decreased after 24 months of treatment, n=19.
- Fat mass decreased after 24 months of treatment, n=19.
- Lean mass increased after 24 months of treatment, n=19.
- Significant changes in bone mineral content and lumbar spine Z-score were observed after 24 months, n=19.
Limitations
- small n=19
- requires validation in larger cohorts
- no consistent associations with skeletal parameters