Effects of human growth hormone in men over 60 years old.

BACKGROUND The declining activity of the growth hormone--insulin-like growth factor I (IGF-I) axis with advancing age may contribute to the decrease in lean body mass and the increase in mass of adipose tissue that occur with aging. METHODS To test this hypothesis, we studied 21 healthy men from 61 to 81 years old who had plasma IGF-I concentrations of less than 350 U per liter during a six-month base-line period and a six-month treatment period that followed. During the treatment period, 12 men (group 1) received approximately 0.03 mg of biosynthetic human growth hormone per kilogram of body weight subcutaneously three times a week, and 9 men (group 2) received no treatment. Plasma IGF-I levels were measured monthly. At the end of each period we measured lean body mass, the mass of adipose tissue, skin thickness (epidermis plus dermis), and bone density at nine skeletal sites. RESULTS In group 1, the mean plasma IGF-I level rose into the youthful range of 500 to 1500 U per liter during treatment, whereas in group 2 it remained below 350 U per liter. The administration of human growth hormone for six months in group 1 was accompanied by an 8.8 percent increase in lean body mass, a 14.4 percent decrease in adipose-tissue mass, and a 1.6 percent increase in average lumbar vertebral bone density (P less than 0.05 in each instance). Skin thickness increased 7.1 percent (P = 0.07). There was no significant change in the bone density of the radius or proximal femur. In group 2 there was no significant change in lean body mass, the mass of adipose tissue, skin thickness, or bone density during treatment. CONCLUSIONS Diminished secretion of growth hormone is responsible in part for the decrease of lean body mass, the expansion of adipose-tissue mass, and the thinning of the skin that occur in old age.

[1]  H. Roffwarg,et al.  Age-related change in the twenty-four-hour spontaneous secretion of growth hormone. , 1972, The Journal of clinical endocrinology and metabolism.

[2]  D. Rudman,et al.  The relationship of growth hormone to alveolar ridge atrophy in an older male nursing home population. , 1988, Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry.

[3]  R. Blizzard,et al.  Growth hormone: metabolic clearance rates, integrated concentrations, and production rates in normal adults and the effect of prednisone. , 1972, The Journal of clinical investigation.

[4]  R. Marcus,et al.  Effects of short term administration of recombinant human growth hormone to elderly people. , 1990, The Journal of clinical endocrinology and metabolism.

[5]  A. Rogol,et al.  Effects of sex and age on the 24-hour profile of growth hormone secretion in man: importance of endogenous estradiol concentrations. , 1987, The Journal of clinical endocrinology and metabolism.

[6]  E. Perez-Pasten,et al.  Body composition in hypopituitary dwarfs before and during human growth hormone therapy. , 1979, Metabolism: clinical and experimental.

[7]  R. Luft,et al.  The relation between extracellular and intracellular water in acromegaly. , 1956, Acta endocrinologica.

[8]  M. Vitiello,et al.  Somatomedin-C levels in healthy young and old men: relationship to peak and 24-hour integrated levels of growth hormone. , 1985, Journal of gerontology.

[9]  J. Meites Neuroendocrine biomarkers of aging in the rat , 1988, Experimental Gerontology.

[10]  R. Leibel,et al.  Effects of systemic growth hormone (GH) administration on regional adipose tissue distribution and metabolism in GH-deficient children. , 1989, The Journal of clinical endocrinology and metabolism.

[11]  C. Lowy,et al.  MORTALITY IN ACROMEGALY1 , 1970 .

[12]  D. Clemmons,et al.  Evaluation of acromegaly by radioimmunoassay of somatomedin-C. , 1979, The New England journal of medicine.

[13]  R. Hintz Plasma forms of somatomedin and the binding protein phenomenon. , 1984, Clinics in endocrinology and metabolism.

[14]  D. Rudman,et al.  Osteopenia in the men of a Veterans Administration nursing home. , 1990, The American journal of clinical nutrition.

[15]  J. Eisman,et al.  Somatomedin-C, physical fitness, and bone density. , 1990, The Journal of clinical endocrinology and metabolism.

[16]  D. Waters,et al.  Body composition response to exogenous GH during training in highly conditioned adults. , 1988, Journal of applied physiology.

[17]  P. Wilton,et al.  Clinical Experience with Genotropin Worldwide: An Update March 1987 , 1987, Acta paediatrica Scandinavica. Supplement.

[18]  J. Petrini,et al.  Acromegaly and colon cancer. , 1984, Annals of internal medicine.

[19]  D. Clemmons,et al.  6 Factors controlling blood concentration of somatomedin C , 1984 .

[20]  H. Müller-Hermelink,et al.  Admission criteria for immunogerontological studies in man: The senieur protocol , 1984, Mechanisms of Ageing and Development.

[21]  A. Liuzzi,et al.  Relationship between somatomedin-C and growth hormone levels in acromegaly: basal and dynamic evaluation. , 1986, Journal of Clinical Endocrinology and Metabolism.

[22]  M. Kutner,et al.  Impaired growth hormone secretion in the adult population: relation to age and adiposity. , 1981, The Journal of clinical investigation.

[23]  R. Furlanetto,et al.  Estimation of somatomedin-C levels in normals and patients with pituitary disease by radioimmunoassay. , 1977, The Journal of clinical investigation.

[24]  S. Shuster,et al.  Comparison of ultrasound and caliper measurements of normal and inflamed skin thickness , 1985, The British journal of dermatology.

[25]  N. Skakkebaek,et al.  BENEFICIAL EFFECTS OF GROWTH HORMONE TREATMENT IN GH-DEFICIENT ADULTS , 1989, The Lancet.

[26]  D. Penney,et al.  Cardiomegaly and haemodynamics in rats with a transplantable growth hormone-secreting tumour. , 1985, Cardiovascular research.

[27]  L. Mandarino,et al.  Effects of Growth Hormone on Insulin Action in Man: Mechanisms of Insulin Resistance, Impaired Suppression of Glucose Production, and Impaired Stimulation of Glucose Utilization , 1982, Diabetes.

[28]  D. Appleton,et al.  EPIDEMIOLOGY OF ACROMEGALY IN THE NEWCASTLE REGION , 1980, Clinical endocrinology.

[29]  L. P. Novâk,et al.  Aging, total body potassium, fat-free mass, and cell mass in males and females between ages 18 and 85 years. , 1972, Journal of gerontology.

[30]  S. Lamberts,et al.  The effects of human growth hormone administration in elderly adults with recent weight loss. , 1988, The Journal of clinical endocrinology and metabolism.

[31]  J. Kraner,et al.  Exogenous growth hormone treatment alters body composition and increases natural killer cell activity in women with impaired endogenous growth hormone secretion. , 1987, Metabolism: clinical and experimental.

[32]  K. Hall,et al.  Somatomedin levels in childhood, adolescence and adult life. , 1984, Clinics in endocrinology and metabolism.

[33]  M. Vance,et al.  Somatotropin pulse frequency and basal concentrations are increased in acromegaly and are reduced by successful therapy. , 1990, The Journal of clinical endocrinology and metabolism.

[34]  L. Phillips,et al.  Nutrition and somatomedin. XIII. Usefulness of somatomedin-C in nutritional assessment. , 1985, The American journal of medicine.

[35]  M. Vance Growth hormone for the elderly? , 1990, The New England journal of medicine.

[36]  M. Flynn,et al.  Total body potassium in aging humans: a longitudinal study. , 1989, The American journal of clinical nutrition.

[37]  S. Shuster,et al.  The influence of age and sex on skin thickness, skin collagen and density , 1975, The British journal of dermatology.

[38]  D. Rudman Growth Hormone, Body Composition, and Aging , 1985, Journal of the American Geriatrics Society.

[39]  B. Bengtsson,et al.  Epidemiology and long-term survival in acromegaly. A study of 166 cases diagnosed between 1955 and 1984. , 2009, Acta medica Scandinavica.

[40]  P. Sönksen,et al.  The effects of treatment with recombinant human growth hormone on body composition and metabolism in adults with growth hormone deficiency. , 1989, The New England journal of medicine.