Study summary · research use only
Tesamorelin improves fat quality independent of changes in fat quantity
Plain-language summary
Paraphrased from the published abstract below — not a verdict on whether anything works.
This study analyzed data from two completed, placebo-controlled, randomized human trials of tesamorelin, a growth hormone-releasing hormone analogue, in people living with HIV with central adiposity. Participants (193 responders to tesamorelin's reduction of visceral fat, and 148 placebo-treated) were 87% male and 83% white. Fat density on CT scan (Hounsfield Units) was measured by a central blinded reader. Over 26 weeks, mean visceral fat density increased by 6.2 (SD 8.7) HU with tesamorelin versus 0.3 (4.2) HU with placebo, and subcutaneous fat density increased by 4.0 (8.7) HU with tesamorelin versus 0.3 (4.8) HU with placebo. These density changes persisted after statistical adjustment for baseline values and area change, which the authors interpret as reflecting changes in fat quality independent of fat quantity.
Abstract
Fat quality and quantity may affect health similarly or differently. Fat quality can be assessed by measuring fat density on CT scan (greater density = smaller, higher quality adipocytes). We assessed the effects of tesamorelin, a growth hormone-releasing hormone analogue that reduces visceral fat (VAT) quantity in some people living with HIV (PWH), on fat density. Participants from two completed, placebo-controlled, randomized trials of tesamorelin for central adiposity treatment in PWH were included if they had either a clinical response to tesamorelin (VAT decrease ≥8%, ≈70% of participants) or were placebo-treated. CT VAT and subcutaneous fat (SAT) density (Hounsfield Units, HU) were measured by a central blinded reader. Participants (193 responders, 148 placebo) were 87% male and 83% white. Baseline characteristics were similar across arms, including VAT (-91 HU both arms, P = 0.80) and SAT density (-94 HU tesamorelin, -95 HU placebo, P = 0.29). Over 26 weeks, mean (SD) VAT and SAT density increased in tesamorelin-treated participants only [VAT: +6.2 (8.7) HU tesamorelin, +0.3 (4.2) HU placebo, P < 0.0001; SAT: +4.0 (8.7) HU tesamorelin, +0.3 (4.8) HU placebo, P < 0.0001]. The tesamorelin effects persisted after controlling for baseline VAT or SAT HU and area, and VAT [+2.3 HU, 95% confidence interval (4.5-7.3), P = 0.001) or SAT (+3.5 HU, 95% confidence interval (2.3-4.7), P < 0.001] area change. In PWH with central adiposity who experienced VAT quantity reductions on tesamorelin, VAT and SAT density increased independent of changes in fat quantity, suggesting that tesamorelin also improves VAT and SAT quality in this group.
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