The effect of growth hormone (GH) replacement on muscle strength in patients with GH‐deficiency: a meta‐analysis

Widdowson, W. Matthew; Gibney, James

doi:10.1111/j.1365-2265.2009.03716.x

Cited by 42 publications

(8 citation statements)

References 37 publications

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“…As such, GH may exert direct systemic effects via receptor dimerization or indirect effects via the stimulation of systemic or local IGF-I expression [1]; although, we did not observe changes in circulating IGF-I following either exercise protocol. Importantly, it is no longer thought that GH stimulates accretion of skeletal muscle mass in adults [5], considering that GH does not induce myofibrillar protein synthesis [2] and that exogenous GH administration does not improve muscle performance in healthy young individuals, GH-deficient individuals [49], or older men [8]. In humans, the primary roles of GH are as a key regulator of fuel metabolism and as an initiator of protein synthesis with connective tissue [50].…”

Section: Discussionmentioning

confidence: 99%

Growth hormone responses to acute resistance exercise with vascular restriction in young and old men

Manini

Yarrow

Buford

et al. 2012

Growth Hormone & IGF Research

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Objective Resistance exercise (RE) stimulates growth hormone (GH) secretion in a load-dependent manner, with heavier loads producing larger GH responses. However, new research demonstrates that low-load RE performed with blood flow restriction (BFR) produces potent GH responses that are similar to or exceed those produced following high-load RE. We hypothesized that low-load RE with vascular restriction would attenuate the known age-related reduction in GH response to RE. Design In a randomized crossover design, ten young (28±7.8 years) and ten older (67.4±4.6 years) men performed bilateral knee extension RE with low-load [20% of one-repetition maximum (1RM)] with BFR and high-load (80% 1RM) without BFR. GH and lactate were measured every 10 minutes throughout a 150-minute testing session (30 minutes prior to and 120 minutes following completion of the exercise); IGF-I was measured at baseline and 60 minutes post-exercise. Results Area under the GH curve indicated that both age groups responded similarly to each exercise condition. However, young men had a significantly greater maximal GH response to low-load RE with BFR than the high-load condition without BFR. Additionally, younger men had greater maximal GH concentrations to low-load RE with BFR than older men (p=0.02). The GH responses were marginally correlated to lactate concentration (r=0.13, p=0.002) and IGF-I levels were unchanged with RE. Conclusions GH responses to low-load RE with vascular restriction are slightly higher than high-load RE without vascular restriction in young men. However, low-load RE with vascular restriction did not attenuate the known age-related reduction in GH response with exercise. These data suggest that while low-load RE with vascular restriction is as effective for inducing a GH response than traditionally-based high-load RE, there is a more potent response in young men.

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Section: Discussionmentioning

confidence: 99%

Growth hormone responses to acute resistance exercise with vascular restriction in young and old men

Manini

Yarrow

Buford

et al. 2012

Growth Hormone & IGF Research

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“… 10 Other similarly designed studies have not shown any such effect on exercise performance. 51 , 54 – 56 …”

Section: Discussionmentioning

confidence: 99%

Effects of human recombinant growth hormone on exercise capacity, cardiac structure, and cardiac function in patients with adult-onset growth hormone deficiency

et al. 2017

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ObjectiveEpidemiological studies suggest that adult-onset growth hormone deficiency (AGHD) might increase the risk of death from cardiovascular causes.MethodsThis was a 6-month double-blind, placebo-controlled, randomised, cross-over trial followed by a 6-month open-label phase. Seventeen patients with AGHD received either recombinant human growth hormone (rGH) (0.4 mg injection daily) or placebo for 12 weeks, underwent washout for 2 weeks, and were then crossed over to the alternative treatment for a further 12 weeks. Cardiac magnetic resonance imaging, echocardiography, and cardiopulmonary exercise testing were performed at baseline, 12 weeks, 26 weeks, and the end of the open phase (12 months). The results were compared with those of 16 age- and sex-matched control subjects.ResultsAt baseline, patients with AGHD had a significantly higher systolic blood pressure, ejection fraction, and left ventricular mass than the control group, even when corrected for body surface area. Treatment with rGH normalised the insulin-like growth factor 1 concentration without an effect on exercise capacity, cardiac structure, or cardiac function.ConclusionAdministration of rGH therapy for 6 to 9 months failed to normalise the functional and structural cardiac differences observed in patients with AGHD when compared with a control group.

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“…Furthermore, IGF-1 also exerts an anabolic action on muscle, increasing the protein synthesis and decreasing the protein breakdown ( 41 , 42 ). In fact, IGF-1 elicits skeletal muscle cell proliferation and myocytes differentiation ( 42 ).…”

Section: Discussionmentioning

confidence: 99%

Bone Status in a Patient with Insulin-Like Growth Factor-1 Receptor Deletion Syndrome: Bone Quality and Structure Evaluation Using Dual-Energy X-Ray Absorptiometry, Peripheral Quantitative Computed Tomography, and Quantitative Ultrasonography

et al. 2017

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Haploinsufficiency of the insulin-like growth factor (IGF)-1 receptor (IGF1R) gene is a rare, probably under-diagnosed, cause of short stature. However, the effects of IGF1R haploinsufficiency on glucose metabolism, bone status, and metabolism have rarely been investigated. We report the case of a patient referred to our center at the age of 18 months for short stature, failure to thrive, and Silver–Russell-like phenotype. Genetic analysis did not show hypomethylation of the 11p15.5 region or uniparental disomy of chromosome 7. Growth hormone (GH) stimulation tests revealed GH deficiency, whereas IGF-1 was 248 ng/mL. r-hGH treatment showed only a slight improvement (from −4.4 to −3.5 SDS). At 10 years of age, the child was re-evaluated: CGH-array identified a heterozygous de novo 4.92 Mb deletion in 15q26.2, including the IGF1R gene. Dual-energy X-ray absorptiometry showed a normal bone mineral density z-score, while peripheral quantitative computed tomography revealed reduced cortical and increased trabecular elements. A phalangeal bone quantitative ultrasonography showed significantly reduced amplitude-dependent speed of sound and bone transmission time values. The changes in bone architecture, quality, and metabolism in heterozygous IGF1R deletion patients, support the hypothesis that IGF-1 can be a key factor in bone modeling and accrual.

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The effect of growth hormone (GH) replacement on muscle strength in patients with GH‐deficiency: a meta‐analysis

Abstract: Evidence from short-term controlled studies fails to support a benefit on muscle strength of GH replacement in GHD patients, which is likely to occur over a longer time-course, as seen in open-label studies.

Cited by 42 publications

References 37 publications

Growth hormone responses to acute resistance exercise with vascular restriction in young and old men

Growth hormone responses to acute resistance exercise with vascular restriction in young and old men

Effects of human recombinant growth hormone on exercise capacity, cardiac structure, and cardiac function in patients with adult-onset growth hormone deficiency

Bone Status in a Patient with Insulin-Like Growth Factor-1 Receptor Deletion Syndrome: Bone Quality and Structure Evaluation Using Dual-Energy X-Ray Absorptiometry, Peripheral Quantitative Computed Tomography, and Quantitative Ultrasonography

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