[The beneficial effects of growth hormone replacement therapy on elderly men]

The relationship of growth hormone (GH) to the ageing process is currently subject of considerably interest. The study was designed to investigate the effects of replacement therapy with growth hormone on quality of life, serum lipids and body composition (fat free mass and fat mass) in elderly men.

18 healthy men 60.0 +/- 2.4 (x +/- SEM) years of age. Their body weight was 78.6 +/- 4.6 kg and body mass index (BMI) was 26.5 +/- 1.4 kg/m2. Diagnosis of GH deficiency was based on serum insulin-like growth factor-1 (IGF-1) levels below 200 micrograms/L (138.1 +/- 9.2), abolished GH nocturnal surge and diminished glucagon-stimulated GH secretion compared to reference group of young men (16.2 +/- 1.8 to 30.6 +/- 4.7 micrograms/L/hour; p < 0.02 and 10.8 +/- 1.0 to 44.1 +/- 15.3 micrograms/L/hour; p < 0.02, respectively). Reference group comprised nine men 27.5 +/- 1.3 years of age with body weight 76.3 +/- 2.2 kg and BMI 23.1 +/- 0.6 kg/m2. The subjects received recombinant, human GH daily subcutaneously during 12 months in dose adjusted to maintain optimal (280-350 micrograms/L) serum IGF-1 level. The initial dose was 0.125 IU/kg b.w./week. Before, and after 6 and 12 months of therapy clinical and laboratory exams, including serum GH, IGF-1 and lipids levels, and body composition using two methods were obtained. Quality of life was assessed by modified Beck's questionnaire. 12-months replacement therapy with growth hormone in elderly men improved mental status, increased serum IGF-1 level to the young normal men values, from 138.1 +/- 9.2 to 279.4 +/- 26.3 micrograms/L, p < 0.001, reduced serum LDL-cholesterol from 3.67 +/- 0.12 to 3.10 +/- 0.21 mmol/L, p < 0.04 and increased serum HDL and HDL2 levels from 1.20 +/- 0.05 to 1.41 +/- 0.08 mmol/L, p < 0.002 and from 0.19 +/- 0.03 to 0.34 +/- 0.06 mmol/L, p < 0.005, respectively, reduced fat mass (12.8%, p < 003), particularly localised in trunk (14.7%, p < 0.03), and increased fat free mass (2.9%, p < 0.03). GH-replacement therapy in elderly men has beneficial effects on quality of life, and may counteract ageing and atherosclerosis progression by serum lipids and body composition improvement.