Post-prandial triglyceride profile after a standardized oral fat load is altered in growth hormone (GH) deficient adult patients and is not improved after short term GH replacement therapy

OBJECTIVE: Adult growth hormone deficiency (GHD) has detrimental effects on metabolic profile leading to an increased cardiovascular mortality and morbidity. Above all, disturbance in postprandial triglyceride metabolism is of major concern because of the crucial role of triglyceride-rich lipoproteins in atherogenesis. The majority of previous studies on GH replacement have shown favorable changes in the fasting lipid profile. Aim of this paper is to investigate if this beneficial effect is exerted also on postprandial triglyceride (TG) metabolism. PATIENTS AND METHODS: We challenged 9 GHD patients with a standardized fat loading meal at baseline and after 6 months of GH replacement therapy. Nine healthy control subjects were similarly tested under baseline conditions. Blood samples were obtained before and up to 8 hours after fat loading for serum lipid analysis RESULTS: We found that GHD patients with fasting TG level in the normal range (1.29 ±0.31 mmo/l) had a delayed postprandial TG clearance compared to healthy controls (triglyceride level at 8h: 3.82 ±0.83 vs 1 ± 0.06 mmol/l P<0.01) and the postprandial hypertriglyceridemia was not corrected by 6 months GH therapy. CONCLUSIONS: This study has shown for the first time that GHD adult patients have a higher post-prandial triglyceridemia compared to healthy controls when challenged by a standardized fat load and that this atherogenic feature is not normalized by short-term GH treatment in spite of a decrease of visceral fat mass described during the replacement therapy