The Effects of Protein Ingestion on GH Concentrations in Visceral Obesity

Abstract

Growth hormone (GH), a hormone originating from the anterior pituitary gland, is an important regulator of metabolism and body composition. Low GH secretion is associated with features of the metabolic syndrome, in particular increased visceral body fat and decreased lean body mass. It has been shown that GH release can be promoted by ingestion of protein, in particular gelatin protein. The question remains; is the GH-promoting effect of gelatin protein also present in a population with blunted GH response, such as visceral obesity? 8 lean women (age: 23±3 years, BMI: 21.6±2.0 kg/m²) and 8 visceral obese women (age: 28±7 years, BMI: 33.8±5.5 kg/m²) were compared with regard to their 5-h GH response after oral ingestion of gelatin protein (0.6 g protein per kg bodyweight), placebo (water), or injection of growth hormone releasing hormone (GHRH) (1 μ/kg body weight), in a randomized crossover design. GH response after placebo, gelatin protein, or GHRH was higher in lean subjects than in visceral obese subjects (p<0.05). Ingestion of gelatin protein increased GH response compared with placebo in both visceral obese (182.1±81.6 μg/l·5 h vs. 28.4±29.8 μg/l·5 h) and lean (631.7±144.2 μg/l·5 h vs. 241.0±196.8 μg/l·5 h) subjects (p<0.05). GH response after ingestion of gelatin protein in visceral obese did not differ from that in lean, placebo-treated subjects (p=0.45). GH concentrations after GHRH injection correlated significantly with GH concentrations after gelatin ingestion (AUC; r=0.71, p<0.01, Peak; r=0.81, p<0.01). Further research is needed to investigate if gelatin protein is able to improve metabolic abnormalities in hyposomatotropism in the long term or to investigate the relevance of protein as diagnostic tool in hyposomatotropism.

Key words

protein - GH - somatotropic axis - hyposomatotropism - visceral obesity

References

• 1 Veldhuis JD, Roemmich JN, Richmond EJ, Rogol AD, Lovejoy JC, Sheffield-Moore M, Mauras N, Bowers CY. Endocrine control of body composition in infancy, childhood, and puberty.  Endocr Rev. 2005;  26 114-146
• 2 Moller N, Jorgensen JO. Effects of Growth Hormone on Glucose, Lipid and Protein Metabolism in Human Subjects.  Endocr Rev. 2009;  30 152-177
• 3 Dicker A, Astrom G, Wahlen K, Hoffstedt J, Naslund E, Wiren M, Ryden M, Arner P, van Harmelen V. Primary differences in lipolysis between human omental and subcutaneous adipose tissue observed using in vitro differentiated adipocytes.  Horm Metab Res. 2009;  41 350-355
• 4 Carrel AL, Allen DB. Effects of growth hormone on adipose tissue.  J Pediatr Endocrinol Metab. 2000;  13 (S 02) 1003-1009
• 5 Gerver WJ, De Bruin R, Delemarre van der Waal HA, Aldewereld B, Theunissen P, Westerterp KR. Effects of discontinuation of growth hormone treatment on body composition and metabolism.  Horm Res. 2000;  53 215-220
• 6 Wajchenberg BL. Subcutaneous and visceral adipose tissue: their relation to the metabolic syndrome.  Endocr Rev. 2000;  21 697-738
• 7 Utz AL, Yamamoto A, Hemphill L, Miller KK. Growth hormone deficiency by growth hormone releasing hormone-arginine testing criteria predicts increased cardiovascular risk markers in normal young overweight and obese women.  J Clin Endocrinol Metab. 2008;  93 2507-2514
• 8 Makimura H, Stanley T, Mun D, Chen C, Wei J, Connelly JM, Hemphill LC, Grinspoon SK. Reduced growth hormone secretion is associated with increased carotid intima-media thickness in obesity.  J Clin Endocrinol Metab. 2009;  94 5131-5138
• 9 Veldhuis JD, Iranmanesh A, Ho KK, Waters MJ, Johnson ML, Lizarralde G. Dual defects in pulsatile growth hormone secretion and clearance subserve the hyposomatotropism of obesity in man.  J Clin Endocrinol Metab. 1991;  72 51-59
• 10 Clasey JL, Weltman A, Patrie J, Weltman JY, Pezzoli S, Bouchard C, Thorner MO, Hartman ML. Abdominal visceral fat and fasting insulin are important predictors of 24-hour GH release independent of age, gender, and other physiological factors.  J Clinical Endocrinol Metab. 2001;  86 3845-3852
• 11 Cordido F, Dieguez C, Casanueva FF. Effect of central cholinergic neurotransmission enhancement by pyridostigmine on the growth hormone secretion elicited by clonidine, arginine, or hypoglycemia in normal and obese subjects.  J Clinical Endocrinol Metab. 1990;  70 1361-1370
• 12 Hartman ML, Crowe BJ, Biller BM, Ho KK, Clemmons DR, Chipman JJ. Which patients do not require a GH stimulation test for the diagnosis of adult GH deficiency?.  J Clin Endocrinol Metab. 2002;  87 477-485
• 13 Vizner B, Reiner Z, Sekso M. Effect of l-dopa on growth hormone, glucose, insulin, and cortisol response in obese subjects.  Exp Clin Endocrinol. 1983;  81 41-48
• 14 Makimura H, Stanley T, Mun D, You SM, Grinspoon S. The effects of central adiposity on growth hormone (GH) response to GH-releasing hormone-arginine stimulation testing in men.  J Clin Endocrinol Metab. 2008;  93 4254-4260
• 15 Buijs MM, Burggraaf J, Langendonk JG, Schoemaker RC, Frolich M, Arndt JW, Cohen AF, Romijn JA, Ackermans MT, Sauerwein HP, Meinders AE, Pijl H. Hyposomatotropism blunts lipolysis in abdominally obese women.  J Clin Endocrinol Metab. 2002;  87 3851-3858
• 16 de Boer H, Blok GJ, Van der Veen EA. Clinical aspects of growth hormone deficiency in adults.  Endocr Rev. 1995;  16 63-86
• 17 Rosen T, Johannsson G, Johansson JO, Bengtsson BA. Consequences of growth hormone deficiency in adults and the benefits and risks of recombinant human growth hormone treatment.  A review paper. Horm Res. 1995;  43 93-99
• 18 Vahl N, Jorgensen JO, Skjaerbaek C, Veldhuis JD, Orskov H, Christiansen JS. Abdominal adiposity rather than age and sex predicts mass and regularity of GH secretion in healthy adults.  Am J Physiol. 1997;  272 E1108-E1116
• 19 Franco C, Brandberg J, Lonn L, Andersson B, Bengtsson BA, Johannsson G. Growth hormone treatment reduces abdominal visceral fat in postmenopausal women with abdominal obesity: a 12-month placebo-controlled trial.  J Clin Endocrinol Metab. 2005;  90 1466-1474
• 20 Johannsson G, Marin P, Lonn L, Ottosson M, Stenlof K, Bjorntorp P, Sjostrom L, Bengtsson BA. Growth hormone treatment of abdominally obese men reduces abdominal fat mass, improves glucose and lipoprotein metabolism, and reduces diastolic blood pressure.  J Clin Endocrinol Metab. 1997;  82 727-734
• 21 Chromiak JA, Antonio J. Use of amino acids as growth hormone-releasing agents by athletes.  Nutrition. 2002;  18 657-661
• 22 Knopf RF, Conn JW, Fajans SS, Floyd JC, Guntsche EM, Rull JA. Plasma Growth Hormone Response To Intravenous Administration Of Amino Acids.  J Clin Endocrinol Metab. 1965;  25 1140-1144
• 23 Isidori A, Lo Monaco A, Cappa M. A study of growth hormone release in man after oral administration of amino acids.  Curr Med Res Opin. 1981;  7 475-481
• 24 Collier SR, Casey DP, Kanaley JA. Growth hormone responses to varying doses of oral arginine.  Growth Horm IGF Res. 2005;  15 136-139
• 25 Sizonenko PC, Clayton PE, Cohen P, Hintz RL, Tanaka T, Laron Z. Diagnosis and management of growth hormone deficiency in childhood and adolescence. Part 1: diagnosis of growth hormone deficiency.  Growth Horm IGF Res. 2001;  11 137-165
• 26 van Vught JAH, Nieuwenhuizen AG, Veldhorst MAB, Brummer RJM, Westerterp-Plantenga MS. Somatotropic effects of soy-, gelatin-, alpha-lactalbumin- and milk protein.  Eur J Clin Nutr. 2010;  64 441-446
• 27 van Vught JAH, Nieuwenhuizen AG, Gerver WJ, Veldhorst MAB, Brummer RJM, Westerterp-Plantenga MS. Pharmacological and physiological growth hormone stimulation tests to predict successful GH therapy in children.  J Pediatr Endocrinol Metab. 2009;  22 679-694
• 28 Frystyk J, Grofte T, Skjaerbaek C, Orskov H. The effect of oral glucose on serum free insulin-like growth factor-1 and -11 in health adults.  J Clin Endocrinol Metab. 1997;  82 3124-3127
• 29 Franco C, Bengtsson BA, Johannsson G. The GH/IGF-1 Axis in Obesity: Physiological and Pathological Aspects.  Metab Syndr Rel Disord. 2006;  4 51-56
• 30 Nam SY, Lee EJ, Kim KR, Cha BS, Song YD, Lim SK, Lee HC, Huh KB. Effect of obesity on total and free insulin-like growth factor (IGF)-1, and their relationship to IGF-binding protein (BP)-1, IGFBP-2, IGFBP-3, insulin, and growth hormone.  Int J Obes. 1997;  21 355-359
• 31 Fineberg SE, Horland AA, Merimee TJ. Free fatty acid concentrations and growth hormone secretion in man.  Metabol Clin Exp. 1972;  21 491-498
• 32 Iranmanesh A, Lizarralde G, Veldhuis JD. Age and relative adiposity are specific negative determinants of the frequency and amplitude of growth hormone (GH) secretory bursts and the half-life of endogenous GH in healthy men.  J Clin Endocrinol Metab. 1991;  73 1081-1088
• 33 Abdul Shakoor SK, Shalet SM. Effects of GH replacement on metabolism and physical performance in GH deficient adults.  J Endocrinol Invest. 2003;  26 911-918
• 34 Carrel AL, Allen DB. Effects of growth hormone on body composition and bone metabolism.  Endocrine. 2000;  12 163-1672
• 35 Jorgensen JO, Pedersen SA, Thuesen L, Jorgensen J, Ingemann-Hansen T, Skakkebaek NE, Christiansen JS. Beneficial effects of growth hormone treatment in GH-deficient adults.  Lancet. 1989;  1 1221-1225
• 36 Mekala KC, Tritos NA. Effects of recombinant human growth hormone therapy in obesity in adults: a meta analysis.  J Clin Endocrinol Metab. 2009;  94 130-137
• 37 Jacobs AJ, Odom MJ, Word RA, Carr BR. Effect of oral contraceptives on adrenocorticotropin and growth hormone secretion following CRH and GHRH administration.  Contraception. 1989;  40 691-699

Correspondence