Metabolic health profile in young adults with Prader-Willi syndrome: Results of a 2-year randomised, placebo-controlled, cross-over GH trial

Abstract

Context

Patients with Prader-Willi syndrome (PWS) have an increased fat mass and decreased lean body mass. GH-treated young adults with PWS who have attained adult height benefit from continuation of growth hormone (GH) treatment, as GH maintained their improved body composition, whereas fat mass increased during the placebo period. Adults with PWS are predisposed to T2DM and CVD. Whether GH affects metabolic health profile of this patient group is unknown.

Objective

To investigate the effects of GH versus placebo on metabolic health, in young adults with PWS who were GH-treated for many years during childhood and had attained adult height (AH).

Method

2-year, randomised, double-blind, placebo-controlled cross-over study with stratification for gender and BMI in 27 young adults with PWS. Intervention with GH (0.67 mg/m²/day) and placebo, both for 1 year duration.

Results

Compared to placebo, GH treatment resulted in similar glucose and insulin levels during oral glucose tolerance test. Only fasting glucose and insulin were slightly higher during GH versus placebo (+0.2 mmol/l and +18.4 pmol/l), although both remained within normal ranges in both phases. Blood pressure and lipid profile were similar after GH versus placebo. At baseline (AH) and during GH, no patients had metabolic syndrome, while 1 developed it during placebo treatment.

Conclusions

GH treatment has no adverse effects on metabolic health profile. Thus, GH-treated young adults with PWS who have attained AH benefit from continuation of GH treatment without safety concerns regarding metabolic health.

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