Growth hormone and insulin-like growth factor-I as anabolic agents

The reduced growth hormone and insulin-like growth factor-I concentrations in growth hormone deficiency and normal ageing are associated with reduced muscle mass and strength, and slower muscle protein synthesis. Recent research has addressed the hypothesis that growth hormone and insulin-like growth factor-I have an anabolic effect in adults, including the elderly. These hormones stimulate whole-body and muscle protein synthesis, at least under some conditions. There is increasing evidence to justify long-term administration of growth hormone to promote muscle growth in growth hormone deficient adults. However, the long-term effects on muscle mass and function in the elderly do not seem beneficial enough to justify widespread hormone replacement therapy. These hormones may be useful anabolic agents to counteract muscle wasting under other conditions, including surgical stress, renal failure, muscular dystrophy, glucocorticoid administration and HIV infection, but more clinical trials are needed to determine the functional significance of the protein anabolic effects under these conditions.