Muscle strength in elderly adults with GH deficiency after 10 years of GH replacement

Abstract

Context: Only few studies have investigated the effects of GH replacement on muscle strength in elderly patients with GH deficiency (GHD). Objective, design, and patients: In this prospective open-labeled study, the effects of 10 years of GH replacement on muscle strength and neuromuscular function were followed in 24 elderly GHD adults (mean age of 65.2 years; range 61-74 years). Muscle strength was compared with reference values obtained from the background population. Results: The mean initial GH dose of 0.72 mg/day was lowered to 0.37 mg/day. The mean IGF1 SDS increased from K1.10 at baseline to 1.17 at study end. GH replacement induced a sustained increase in lean body mass and a transient increase in isometric knee flexor strength. Isometric knee extensor strength was reduced after 10 years. However, after correction for age and gender, using observed/predicted value ratios, there was sustained and even progressive increase in most variables reflecting muscle strength. Measurements of neuromuscular function showed unchanged voluntary motor unit activation after 10 years. Conclusions: Ten years of GH replacement therapy in elderly GHD adults resulted in a transient increase in isometric knee flexor strength, and provided protection from most of the normal age-related decline in muscle performance and neuromuscular function.

GH replacement therapy in elderly GH-deficient patients: a systematic review

“…However, only eight different cohorts of patients were described in these 14 studies, because several studies described data from the same patient cohort. The studies by Götherström et al (12,19) and Toogood et al (20) (nZ12) also described the same patient cohort. Therefore, the data of these studies are described in combination.…”

“…Two studies did not specify the age of the patient, but only indicate that all patients are O60 years (10,11). One study assessed patients between the age 60 and 70 years (22), and in three studies, the age ranged between 60 and 75 years (12,21,23). Five studies included patients O75 years and only two of these studies included patients with age O80 years (14-17, 24).…”

“…Different tests, however, were used, including insulin tolerance test (ITT), combined GHRH plus arginine (GHRHCarginine) test, glucagon stimulation test or stimulation with arginine alone (Table 1). The ITT was used in the total population or in the majority of patients in seven studies (11,12,15,17,(21)(22)(23). The study by Koltowska et al (10) did not mention which tests were used to diagnose GHD.…”

“…Some studies in elderly patients with GHD documented that, rhGH improved quality of life (QoL) (10,11), BC (12)(13)(14) and lipoprotein profiles (11,15,16), although another study showed no effects (17). A consensus statement on the treatment of GHD adults states that 'the age-related decline in the GH-IGF1 status does not warrant rhGH supplementation, but patients with proven GHD should be treated'.…”

Erişkinlerde büyüme hormonu tedavisi

“…Tedavi devam ettiği sürece bu olumlu etki sürmektedir. BH eksikliğinde görülen yağsız vücut kitlesindeki azalma tedavi ile düzelir ve kas kitlesi artar [19]. Çocukluk döneminde başlayan BH eksikliğinde %35, erişkin başlangıçlı BH eksikliğinde %20 oranında osteoporoz görülmektedir.…”