Maintaining Lean Body Mass After Bariatric Surgery

Morbidly obese patients who undergo bariatric surgery could benefit from subsequent treatment with recombinant human growth hormone (rhGH) for six months to prevent the loss of lean body mass, according to a new study.

Researchers from University Federico II (Naples, Italy) investigated the potential role of GH treatment in affecting body weight loss in 24 morbidly obese women undergoing laparoscopic-adjustable silicone gastric banding (LASGB) with subsequent GH deficiency. Twelve of the women were admitted for the treatment protocol, which included a standardized diet regimen and exercise program plus rhGH. The control group, which included the other 12 women, followed a standardized diet regimen and an exercise program alone. The follow-up duration was six months.

The study results showed that the 12 patients treated with rhGH and those given placebo experienced similar weight loss, expressed as excess of body weight lost (EBWL), but patients treated with rhGH had lower loss of lean body mass and higher loss of fat mass at three months. The percentage changes in fat mass and lean body mass were significantly different in the rhGH treatment group compared with the placebo group at both three and six months. Additionally, insulin sensitivity and total cholesterol to high-density lipoprotein (HDL) cholesterol ratio improved only among patients taking rhGH. The study was published in the March 2009 issue of the Journal of Clinical Endocrinology & Metabolism (JCEM).

"This evidence opens a new frontier for GH therapy in the management of morbid obese patients, and might allow a better understanding of the physiological relevance of GH to the pathogenesis of the multiple maladaptive endocrine changes involved in the pathogenesis of obesity and the metabolic syndrome,” concluded lead author Silvia Savastano, M.D., and colleagues.

Growth hormone is a hormone that stimulates growth and cell reproduction in humans and other animals. It is a 191-amino acid, single chain polypeptide hormone that is synthesized, stored, and secreted by the somatotroph cells within the lateral wings of the anterior pituitary gland. Somatotrophin refers to the growth hormone produced natively in animals, and the term somatropin refers to the human growth hormone produced by recombinant DNA technology.

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