Growth Hormone (GH) Status and Body Composition in Normal Ageing and in Elderly Adults with GH Deficiency

Toogood, Andrew

doi:10.1159/000071234

Cited by 48 publications

(30 citation statements)

References 16 publications

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“…By contrast, the baseline and placebo-treated IGF1 concentrations were slightly higher in the male GH-2004 subjects, which may reflect their younger age (17). Consequently, the baseline and placebo-treated GH-2000 score was lower in the GH-2004 study.…”

Section: Peak Igf1mentioning

confidence: 74%

The GH-2004 project: the response of IGF1 and type III pro-collagen to the administration of exogenous GH in non-Caucasian amateur athletes

Holt

Erotokritou‐Mulligan

McHugh

et al. 2010

European Journal of Endocrinology

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Context: The GH-2000 team proposed a method based on IGF1 and type III pro-collagen (P-III-P) to detect exogenously administered GH. As previous studies involved predominantly white European athletes, it is important to assess whether the response of these markers to recombinant human GH (rhGH) differs with ethnicity. Objective: To examine the response of serum IGF1 and P-III-P and GH-2000 score to rhGH in non-Caucasian amateur athletes. Design: Double-blind placebo-controlled rhGH administration study. Setting: Wellcome Trust Clinical Research Facility, Southampton General Hospital. Subjects: The study included 31 male and 14 female amateur athletes of different ethnicities. Intervention: The subjects were assigned to treatment with placebo or 0.1 IU/kg per day (low dose) or 0.2 IU/kg per day (high dose) rhGH for 28 days. Blood was collected weekly during treatment and on days 35, 42 and 84 during the washout period. Serum IGF1 and P-III-P were measured, and GH-2000 score was calculated. Results: IGF1, P-III-P and GH-2000 score rose in response to both low-and high-dose GH in both men and women. When compared with the Caucasian volunteers of the previous GH-2000 study, mean baseline and placebo-treated P-III-P and GH-2000 score were lower in GH-2004 men and women. Post-GH, however, peak IGF1 or P-III-P did not differ between studies but the peak GH-2000 score was lower in GH-2004 men. There was no difference between studies in the maximal change in IGF1, P-III-P and GH-2000 score in response to GH in either gender. Conclusions: These data do not support a significant ethnic effect on the peak or maximal response to rhGH.

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Section: Peak Igf1mentioning

confidence: 74%

The GH-2004 project: the response of IGF1 and type III pro-collagen to the administration of exogenous GH in non-Caucasian amateur athletes

Holt

Erotokritou‐Mulligan

McHugh

et al. 2010

European Journal of Endocrinology

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“…of the reference age despite having clearly low GH peaks (below 3 mg/l) at an insulin tolerance test. Most of the patients had complete pituitary insufficiency supporting the likelihood of having a true GHD (43). Normal IGF-I levels within the reference range were, in particular, seen in men above the age of 40.…”

Section: Discussionmentioning

confidence: 86%

Effects of gastric bypass on the GH/IGF-I axis in severe obesity – and a comparison with GH deficiency

Engström¹,

Burman²,

Holdstock³

et al. 2006

eur j endocrinol

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Objective: Overfeeding suppresses GH secretion and makes evaluation of a suspected GH deficiency (GHD) difficult. In normal weight subjects, gender is known to influence GH concentrations, which is most apparent in the ambulatory, morning-fasted state. In this study, we examined the GH/IGF-I axis in obese men and women and the effect of surgically induced weight loss. Design: Sixty-three subjects (body mass index (BMI) 45^6 kg/m 2 ; 54 women, 9 men) were studied prior to, and 6 and 12 months following Roux-en-Y gastric bypass (RYGBP) surgery. Fifty-four patients with classic GHD (BMI 27^6 kg/m 2 ; 35 men, 19 women) were included for comparison. Methods: Hormones were analysed in fasting morning serum samples. Results: RYGBP resulted in a decreased BMI to 35^kg/m 2 at 6 months and 32^6 kg/m 2 at 12 months. GH and IGF-I increased at 6 months in the women and at 12 months in both sexes by $ 300 and 11% respectively. Prior to RYGBP, GH concentrations were low in the obese men and similar to those of GHD men (mean 0.09 mU/l). Obese women had tenfold higher values than obese men and sevenfold higher than GHD women. IGF-I levels were in the low reference range in the obese and below 22 S.D. for age in 13%. Conclusions: Surgically induced weight loss partially restores GH secretion. Despite a marked suppression of GH values, a gender influence is maintained in severe obesity. In obese women, single morning GH and IGF-I values seem sufficient to exclude a suspicion of classic GHD.European Journal of Endocrinology 154 53-59

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“…Spontaneous GH secretion falls by 14% per decade of adult life [59]. Normal ageing is associated with body composition changes similar to those evident in GHD [4, 60]. Old age can be considered a state of functional GH insufficiency (GHI).…”

Section: Assessment Of Ghd In Adultsmentioning

confidence: 99%

“…Identification of GHD in elderly individuals with H-P disease is important, since they do have changes in body composition, abnormal lipid profiles, and impairment of quality of life similar to those in younger adults [62], and many of these clinical characteristics improve with rhGH therapy [60, 62, 63]. The presence of GHD in these older individuals (>60 years) causes a greater reduction in GH secretion than that which occurs simply with ageing [51, 64].…”

Section: Assessment Of Ghd In Adultsmentioning

confidence: 99%

Defining Growth Hormone Status in Adults with Hypopituitarism

Kaushal

Shalet²

2007

Horm Res Paediatr

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The identification of adults with severe growth hormone (GH) deficiency (GHD) is not straightforward. The insulin tolerance test remains the gold standard diagnostic test, although other stimuli such as GH-releasing hormone-arginine are gaining acceptance. Insulin-like growth factor-I has a poor diagnostic sensitivity in adult-onset GHD, but is more useful in the subgroup of adults with childhood-onset GHD. Therapeutic developments include increasing recognition of the need to continue GH therapy beyond final height in young adults with severe GHD on retesting. Consensus guidelines have provided a useful algorithm to identify individuals requiring retesting and the number of tests needed. The concept of partial GHD, recognized by paediatric endocrinologists for many years, is being examined in adults with hypothalamic-pituitary disease. Preliminary evidence suggests that this entity is associated with metabolic and anthropometric abnormalities intermediate between those in severe GHD and in healthy controls. It remains to be seen whether this subgroup will derive benefit from GH therapy. To date, therapeutic benefits of GH have been demonstrated only in adults with severe GHD. It is, therefore, imperative that these individuals are unequivocally identified; the diagnosis becomes more uncertain in the presence of obesity, increasing age, and in the absence of additional pituitary hormone deficits.

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Growth Hormone (GH) Status and Body Composition in Normal Ageing and in Elderly Adults with GH Deficiency

Cited by 48 publications

References 16 publications

The GH-2004 project: the response of IGF1 and type III pro-collagen to the administration of exogenous GH in non-Caucasian amateur athletes

The GH-2004 project: the response of IGF1 and type III pro-collagen to the administration of exogenous GH in non-Caucasian amateur athletes

Effects of gastric bypass on the GH/IGF-I axis in severe obesity – and a comparison with GH deficiency

Defining Growth Hormone Status in Adults with Hypopituitarism

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