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Geriatric Growth Hormone Interventions Not Ready For Clinical Use
11/13/2002
By Elda Hauschildt
Growth hormone therapy, with and without sex steroids, increases lean body mass and decreases fat mass in healthy older men and women.
Researchers in the United States warn, however, that rate of adverse effects indicate the interventions are not ready for clinical use and should be reserved for controlled studies. These side effects include diabetes and glucose intolerance.
Growth hormones plus sex steroids also increase muscle strength marginally and maximum oxygen uptake in men. But, investigators from the US National Institutes of Health in Bethesda and Johns Hopkins University in Baltimore, both in Maryland, say there was no significant change in strength or cardiovascular endurance in women. "The beneficial effects of growth hormone appeared to be augmented by co-administration of testosterone but not hormone replacement therapy (HRT)," they explain.
The researchers enrolled 57 women and 74 men, aged 65 to 88 years, in a 26-week, randomised, double-blind, placebo-controlled trial. Participants in the parallel-group study were healthy, ambulatory and lived in the community when recruited between June 1992 and July 1998.
A total of 35 participants received subcutaneous growth hormone three times a week plus sex steroids: HRT (transdermal estradiol plus oral medroxyprogesterone acetate) for women and testosterone enanthate for men. Another 30 participants received growth hormone plus placebo sex steroid, and 35 other participants were given sex steroid plus placebo growth hormone. The final group of 31 participants received placebo growth hormone and placebo sex steroids.
Lean body mass increased in women by 0.4 kilograms with placebo, 1.2 kg with HRT, 1 kg with growth hormone and 2.1 kg with both growth hormone and HRT. Fat mass decreased significantly in women in both the growth hormone and growth hormone plus HRT groups.
In men, lean body mass increased by 0.1 kg with placebo, 1.4 kg with testosterone, 3.1 kg with growth hormone and 4.3 kg with growth hormone plus testosterone. Like the women, fat mass also decreased significantly with growth hormone and growth hormone plus sex steroids.
The men's strength did not increase except for a marginally significant increase with growth hormone plus testosterone. Their maximum oxygen uptake increased with growth hormone and growth hormone plus testosterone.
Diabetes or glucose intolerance occurred in 18 men treated with growth hormone, compared with seven of those not receiving the hormone.
JAMA, 2002; 288: 2282-2292
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