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Adult Growth Hormone Deficiency - Somatopause Mounting evidence reveals GHD (somatotropin deficiency) impacts a patient’s quality of life, impairs health (such as microvascular alterations), body composition and regional tissue distribution. All are responsive to growth hormone replacement. The key is in properly identifying GHD patients. Review current research and medical articles on reliable tools for GHD identification, the efficacy and safety of GH therapy, short and long-term effects of recombinant hGH, treatment with sleep disorders, among other relevant issues. Fountain of Youth Overflows with Hormones.pdf
According to this article, as baby boomers
age, the fight against aging is being
combated by increased exercise, better
eating habits and the use of testosterone
and other hormone replenishments.
The aim of the study was to characterize
lipid oxidation at exercise in adults with
growth hormone deficiency (GHD) and to
evaluate the effect of 6 and 12 months of GH
replacement therapy on substrate
carbohydrate (CHO) and lipid utilization at
exercise. The findings are consistent with
the hypothesis that a lack of GH reduces the
ability to oxidize lipids during exercise
and that GH treatment restores this muscular
metabolic property.
This study concluded that excessively high
IGF-I levels can be avoided by
individualized dosing during long-term GH
treatment. Individualized dosing maintains
the decrease in abdominal fat in adult
Japanese GHD patients and should reduce the
cardiovascular risk.
This article, which quotes Dr. Alan Mintz,
describes the increased use of human growth
hormone by aging but relatively healthy
people who hope to improve the quality, and
perhaps the length, of their lives. It
includes discussion for and against the use
of growth hormone.
This study
concluded that an atherogenic lipid profile,
insulin resistance, obesity, and increased
body and trunk fat in GHD adults may cause
the higher risk of cardiovascular disease in
these patients. GHD adults should receive
human recombinant GH along with conventional
replacement therapy. This may be a useful
method in protecting against early onset of
atherosclerosis, metabolic disturbances, and
osteoporosis, especially in young patients. A Drug’s Promise (or not) of Youth.pdf
The author of
this article says that growth hormone is the
anti-aging industry’s most potent and
controversial weapon. Some say it works
wonders. Some say it could shorten your
life. Does Growth Hormone Cause Cancer?.pdf
This study
concluded that even if GH/IGF-1 therapy does
result in a small increase in cancer risk
compared to untreated patients with GH
deficiency, it is likely that the eventual
risk will be the same as the general
population. Such a restoration to normality
will need to be balanced against the known
morbidity of untreated GH deficiency. Hormones May Hold Clues to Healthy Aging.pdf
Two new
studies suggest that specific hormones may
play a key role in longevity and healthy
aging. Researchers found one hormone,
adiponectin, at higher-than-average
concentrations in 100-year-old women, while
another study found that stimulating the
body's production of growth hormone brought
a youthful pep back to people in their 60s
to 80s.
This study
was undertaken to determine the
physiological range of these GH-dependent
variables in elite athletes after a
competitive event to determine whether such
values differ from resting values in normal
and athletic subjects and to establish
whether any adjustments to this range are
required on the basis of age, gender,
demographic characteristics, or the nature
of the exercise performed.
According to
this study, 17b-estradiol may be as
important contributor to insulin-like growth
factor-I (IGF-I) plasma level as age in
hypoestrogenic, hypogonadotropic women.
This study
concluded that the synthesis of CRP is not
affected by a history of ICP. It is readily
and dose dependently stimulated by oral but
not by transdermal E2 in as soon as 2 wk. GE Healthcare Announces Most Extensive Body Composition Reference Database in China.pdf
GE Healthcare, a unit of General Electric
Company (NYSE: GE), announced that the
company has developed the most extensive
body composition reference database to
evaluate total body composition in Chinese
women. The reference database provides
improved confidence for Chinese physicians
in evaluating clinical conditions such as
obesity, eating disorders, diseases that
cause muscle wasting, and conditions that
may increase the risk of diabetes and heart
disease.
The new reference database was presented at
the 27th Annual Meeting of the
American Society for Bone and Mineral
Research meeting in Nashville, TN September
23-27.
The
conclusion of this study was that cardiac
performance is correlated with the GH status
because significant impairment was found in
patients with severe and partial GHD but not
in non-GHD hypopituitary patients. Insulin-Like Growth Factor-1 as a Vascular Protective Factor.pdf
According to
this study, until recently, IGF-1 was
considered a mediator of vascular disease.
Increasing evidence indicates, instead, that
IGF-1 protects against endothelial
dysfunction, atherosclerotic plaque
development, the metabolic syndrome,
clinical instability, and ischemic
myocardial damage. The Serum Growth Hormone to Somatostatin Ratio is Skewed Upward in Rheumatoid Arthritis Patients.pdf
These results
of this study indicated that symptomatic RA
is associated with elevated serum growth
hormone without concomitant changes in IGF-1
compared to individuals from the control
group. Reduced somatostatin levels in older
RA patients resulted in a skewed upward
growth hormone to somatostatin ratio. It was
concluded that the serum growth hormone to
somatostatin ratio may be a useful surrogate
marker of disease activity in symptomatic
RA.
This study
concluded that GH replacement therapy should
be initiated at a low dose and titrated to a
dose producing maximal benefits without
adverse side effects and an IGF-I level
within the age- and sex-adjusted normal
range. Potential Anabolic Effects of Androgens on Bone.pdf
With the
decrease of estrogen at menopause, the need
for androgens increases in post-menopausal
women. Androgens also appear to be
important for the bone health of women who
are pre-menopausal.
This study concluded that GHRH was well
tolerated and effectively increased levels
of IGF-1 in HIV-infected men with
lipodystrophy. Total and regional body
composition improved in response to GHRH,
with increased lean mass and reduced truncal
and visceral fat. Use of GHRH may
potentially be a beneficial treatment
strategy for this population. The Paradox of the Insulin/IGF-1 Signaling Pathway in Longevity.pdf
This review
focuses on the downstream cascade of events
in the insulin and IGF-1 signaling to
identify specific pathways that are relevant
to human longevity. Long-Term Improvement of Quality of Life During Growth Hormone (GH)
This study
demonstrates that 1) improvements in QoL, as
measured by the QLS-H, are maintained during
long-term GH replacement therapy of adults
with GHD, and 2) the QLS-H is a useful tool
for evaluating QoL in hypopituitary patients
treated in clinical practice. The authors
suggest that evaluation of QoL should be a
part of the routine clinical management of
adult GH-deficient patients, complementing
the measurement of surrogate biological
markers or other clinical end points. Growth Hormone Replacement Therapy Appears Safe in Long Term.pdf
Rates of
death, cancers, and intracranial tumor
growth do not appear to be increased by
growth hormone replacement therapy in
adults, Mark L. Hartman, M.D., reported at
the 12th International Congress of
Endocrinology. Effects of Growth Hormone Replacement on Parathyroid Hormone Sensitivity and Bone Mineral Metabolism.pdf
The results
of this study demonstrate that GH may have a
regulatory role in bone mineral metabolism,
and our data provide a possible underlying
mechanism for the development of
osteoporosis in AGHD patients. The changes
observed after GHR may further explain the
beneficial effects of GHR on bone mineral
density that have consistently been
reported. Reduced Longevity in Untreated Patients with Isolated Growth Hormone Deficiency.pdf
The aim of
this study was to analyze the impact of
untreated GHD on life span. Hereditary
dwarfism was recognized in 11 subjects.
Growth Hormone Therapy in Adults.pdf
These
preliminary data suggest that, in adolescent
patients with severe GHD, discontinuation of
GH at completion of growth may limit the
attainment of peak bone mass in this patient
group. This may predispose to clinically
significant osteopenia in later adult life. Testosterone and Atherosclerosis.pdf
This article
concludes that the overall effect of
administration of testosterone on
cardiovascular-disease risk is difficult to
assess because androgens have such an
extraordinary array of effects in vivo.
This report is based on a thorough review
of published studies of the safety and
efficacy of GH therapy in children and
adults. Summarized herein are the
indications for GH use in adults and
children, the conditions for which GH use
has been investigated but is not approved,
and the potential adverse effects of GH
therapy. The authors believe that these
guidelines will help clinical
endocrinologists in the treatment of
patients with recombinant GH.
Effects of Growth Hormone Secretion on Body
Composition in Patients with Crohn’s
Disease.pdf
Twenty
patients undergoing abdominal surgery
participated in this placebo-controlled
randomized double-blind trial. Each patient
was given human growth hormone
subcutaneously for a period of days leading
up to and following the operation.
The aim of
this study was to identify a range of IGF-I
values commensurate with GHD, which could be
used to determine the risk of functional GHD
during the treatment of adult GH disorders.
This study
concludes that greater levels or production
of the catabolic cytokines TNF-alpha and
interleukin 6 are associated with increased
mortality in community-dwelling elderly
adults, whereas IGF-1 levels had the
opposite effect.
It is
concluded that one year discontinuation of
GH treatment leads to a decrease in QoL
within 6 months which effect is counteracted
within 6 months after restart of GH
treatment. Can Growth Hormone Prevent Aging?.pdf
This article cites the
article by Rudman et al. that appeared in
the Journal in 1990 that reported the effect
on body composition of administering human
growth hormone for six months to 12 older
men. This article incited a proliferation of
"antiaging" clinics and lay publications,
such as "Grow Young with HGH," extolling the
benefits of growth hormone in reversing or
preventing aging.
This study
concluded that in elderly patients
undergoing total hip replacement,
preoperative GH treatment results in
improvements in lean body mass and skeletal
muscle mass that are sufficient to offset
postoperative losses. The treatment may
also preserve or improve muscle strength and
postoperative walking ability.
Observational data
confirm some important aspects of diagnosis
of the adult GHD syndrome and of efficacy
and safety of GH replacement. Specifically,
GH replacement therapy of GHD patients in
HypoCCS induced significant long-term
efficacy in terms of body composition and
lipid profiles.
The
conclusion of this study was that this
genetically homogeneous isolated GHD
population presents a syndrome characterized
by central obesity, dyslipidemia, and
elevated SBP but reduced cardiac dimensions
compared with controls.
This study
concluded that 12 months of GH replacement
normalized IGF-I and improved lipid profile
and cardiac performance in adult GHD
patients. A similar period of GH deprivation
induced a further impairment of lipid
profile and cardiac performance. This
finding strongly supports the need of GH
replacement in adult GHD patients.
Shouldn't Adults with Growth Hormone Deficiency Be Offered Growth Hormone Replacement Therapy?.pdf
This analysis
should encourage reluctant practitioners to
at least consider growth hormone replacement
therapy for patients with definite growth
hormone deficiency--that is, patients with
symptomatic panhypopituitarism.
Thirteen
adult patients with severe GH-deficiency (GHD)
were evaluated in this study. The objective
was to evaluate the microcirculation and
vascular reactivity in a GHD state before
and during GH replacement. Growth Hormone Therapy for Adults: Not Ready for Prime Time?.pdf
This article
states that long-term studies in patients
receiving appropriate comprehensive
management for other hormonal deficiencies
and for concomitant abnormalities will be
required to convince physicians of the
utility and safety of growth hormone
replacement therapy.
This study
suggests that GH replacement therapy is safe
and efficacious for the correction of GH
deficiency in survivors of childhood acute
lymphoblastic leukemia (ALL). Inappropriate Serum Levels of IGF-I and IGFBP-3 in Patients with Rheumatoid Arthritis.pdf
In this
study, it was found that
the ratio of IGF-I to IGFBP-3 in RA
patients was significantly
lower than that in controls. These
findings suggest that that
an inappropriate balance of IGF-I
and IGFBP-3 levels may reduce
the availability of IGF-I and
be involved in pathogenesis of
RA. GH-Deficient Survivors of Childhood Cancer: GH Replacement During Adult Life.pdf
This article
proposes that, as in patients with
hypopituitarism caused by pituitary disease,
the main indication for GH replacement in GH-deficient
survivors of childhood cancer should be
severe impairment of quality of life.
A study
involving seven normotensive, nondiabetic GH-deficient
adults (two women) evaluated skin capillary
permeability and capillary density. It
found that the growth hormone deficiency
syndrome is associated with microvascular
alterations, which are responsive to growth
hormone replacement.
This study
concludes that GH therapy does not appear to
increase the risk of disease recurrence or
death in survivors of childhood cancer. The
increased number of SN, particularly in
survivors of acute leukemia, is of concern,
but the data need to be interpreted with
caution given the small number of events.
Growth Hormone Treatment and Neoplasia-Coincidence or Consequence?.pdf
This special
editorial by the Lawson Wilkins Pediatric
Endocrine Society (LWPES) Writing Committee
discusses the article by Swerdlow et al in
Lancet, which reports on the risk of
cancer in patients treated with human
pituitary GH in the United Kingdom from 1959
to 1985.
The
interpretation of this study is that
although based on small numbers, the risk of
colorectal cancer is of some concern and
further investigation in other cohorts is
needed. They have no evidence as to whether
growth hormone in modern dosage regimens is
associated with an increased risk of
colorectal cancer. Assessment of Growth Hormone Dynamics in Human Immunodeficiency Virus-Related Lipodystrophy.pdf
The data from this study demonstrate normal
GH pulse frequency and insulin-like growth
factor-I concentrations but reduced mean GH
concentrations, basal GH concentrations, and
GH pulse amplitude in patients with HIV
lipodystrophy. Increased visceral adiposity
is the strongest predictor of reduced GH
concentrations in HIV lipodystrophy. Further
studies are necessary to determine the
clinical significance of reduced GH in
patients with HIV lipodystrophy. Oral Estrogen May Aggravate Metabolic Abnormalities in Women with Growth Hormone Deficiency.pdf
Oral
administration of estrogen replacement
therapy suppresses the biological actions of
growth hormones (GH) in GH-deficient women,
research suggests. Findings demonstrate for
the first time that the impact of oral
estrogen extends beyond effects on
circulating insulin growth factor I (IGF-I)
levels as GH-induced stimulation of fat
oxidation, protein metabolism are also
affected.
According to
this study, the extensive data, to date,
collected on large numbers of children and
adults treated with GH indicate that for the
current approved indications GH is safe.
Nevertheless, this workshop has highlighted
a number of areas where ongoing surveillance
of the long-term safety of GH replacement is
important (cancer, glucose homeostasis,
high-dose pharmacological treatment). This
will require appropriately designed
follow-up studies using adequate
epidemiological tools and untreated
controls.
This study
discusses how low-dose GHR improves body
composition and QoL as early as 1 month
after commencement and the beneficial
effects continue at 3 months. Most
importantly, these changes occur in the
absence of side-effects. Editorial: Growth Hormone and Cardiovascular Disease: An Area in Rapid Growth.pdf
According to
this editorial, there is good evidence that
GH deficiency as well as GH excess results
in an increased cardiovascular risk. Because
the effect of excess GH is laden with its
own burden, continued critical assessment of
optimal dosing becomes increasingly
important with the widening use of GH
therapy. Longer, prospective studies are,
therefore, needed to assess the long-term
risk for cardiovascular disease in GH-treated
patients.
This study
concluded that GH therapy in GH-deficient
adults is able to progressively increase BMD
and bone area at the lumbar spine over a
period of at least 6 years. However, the
authors state that their study has several
limitations, making it necessary to confirm
these findings in further long-term studies.
This article
concludes that GH replacement for 12 months
significantly improved lipid profile,
decreased fibrinogen levels, and increased
LVMi and LVEF in young adults with co- or
ao-GHD. However, lipid profile, fibrinogen
levels, and systolic function remained
abnormal compared with those in age- and
sex-matched controls, suggesting that a
longer period of GH replacement is necessary
to normalize cardiovascular parameters and
reverse the cardiovascular risk of these
patients. This article concludes that the QLS(M)-H questionnaire is concise, easy to complete, and can be effectively applied across different cultural backgrounds. Psychometric evaluation of the questionnaire reveals that it is a valid, reliable and sensitive tool useful for assessing impaired life satisfaction in adult patients with GHD and also for monitoring the efficacy of GH therapy.
Herschbach, P.,
Henrich, G., Strasburger, C.J., Feldmeier,
H., Marin, F., et al. (2001). Development
and psychometric properties of a
disease-specific quality of life
questionnaire for adult patients with growth
hormone deficiency [Electronic version].
European Journal of Endocrinology/European
Federation of Endocrine Societies,
145(3), 255-65. Retrieved September 14,
2005. This study concluded that increased levels of IGFBPs in RA may result in the reduced availability of free IGFs that can bind to IGF receptors. The observed changes in the IGF system may thus participate in the catabolic processes in rheumatoid arthritis. Neidel, J. (2001). Changes in systemic levels of insulin-like growth factors and their binding proteins in patients with rheumatoid arthritis [Electronic version]. Clinical and Experimental Rheumatology, 19(1), 81-84. Retrieved October 25, 2005. Hormonal Effects on Skin Aging.pdf
This article
reviews the effect of decreasing hormone
levels on the skin and the possible benefits
of hormone replacement therapy (HRT). It
also discusses the positive effects Growth
Hormone and estrogen can have on wound
healing. Recombinant Human Growth Hormone in Patients with Acute Renal Failure.pdf
According to
this study, administration of rhGH to
critically ill patients with acute renal
failure resulted in improvements in negative
nitrogen balance and a significant decrease
in total nitrogen appearance rate. These
changes corresponded to increases in serum
growth hormone, IGF-1, IGF-1 binding protein
3, and leptin levels after growth hormone
administration.
According to
this study, oral estrogen antagonizes
several of the metabolic actions of GH. It
may aggravate body composition abnormalities
already present in GHD women and attenuate
the beneficial effects of GH therapy.
Estrogen replacement in GHD women should be
administered by a nonoral route.
This article
states that recent availability of
recombinant human growth hormone (GH) has
led to intense investigation of the
consequences of adult GH deficiency (GHD)
and the effects of GH replacement. These
studies have led to the identification of a
characteristic syndrome of GHD consisting of
decreased mood and well-being, with
alterations in body composition and
substrate metabolism.
Effects of 7 Years of Growth Hormone Replacement Therapy in Hypopituitary Adults.pdf
This study
concludes that prolonged GH substitution in
middle-aged hypopituitary adults causes a
sustained improvement in body composition.
Other benefits, e.g. on lipid levels and
exercise tolerance, were not apparent at 7
yr when comparisons were made with GH-untreated
hypopituitary controls. Potentially adverse
effects on glucose tolerance and insulinemia
did not develop with prolonged GH therapy.
The results
of the present study suggest that the
potency of GH is altered in patients on
transdermal compared to oral estradiol
therapy. Further investigation should be
undertaken to answer the question whether
the increase in serum IGF-I levels is due to
lower serum levels of estradiol or to
differences in the mode of administration of
estradiol.
This study
concludes that treatment with rhGH of adult
chronic hemodialysis patients for 6 months
increased the left ventricular mass
significantly, but without any effect on
ejection fraction or maximal working
capacity. No electrocardiographic signs of
ischemia were associated with the increasing
muscle mass and only one patient developed
symptoms that might relate to ischemia. No
changes in B-Hb, blood pressure or pulse
were observed during the treatment period. Growth Hormone - Hormone Replacement for the Somatopause?.pdf
According to
this article, the fall in GH secretion seen
with ageing coincides with changes in body
composition and lipid metabolism that are
similar to those seen in adults with GH
deficiency. In elderly subjects, although GH
secretion is markedly reduced, remaining GH
secretion correlates closely with body
composition (particularly with lean body
mass and inversely with central abdominal
fat).
The present
study confirms short-term data published in
the literature on a sex difference in rhGH
dose requirement in GH-deficient patients.
It furthers extends the data by
demonstrating that this sex difference in GH
responsivity persists and changes during the
24 months of the study. Moreover, it shows
that estrogen replacement blunts the IGF-I
response to rhGH in women, whereas in men
with androgen substitution the responsivity
increases over time, thus bearing a risk of
undertreatment in women and overtreatment in
men. Interrelationships Between Growth Hormone and Sleep.pdf
This study
discusses how during ageing, slow-wave (SW)
sleep and GH secretion decrease
exponentially and with the same chronology.
Pharmacological stimulation of SW sleep
results in increased GH release, and
compounds that increase SW sleep may
therefore represent a novel class of GH
secretagogues. Growth Hormone, Insulin-Like Growth Factor I and Cognitive Function in Adults.pdf
This review
focuses on the possible contribution of the
growth hormone (GH)-insulin-like growth
factor I (IGF-I) axis to cognitive function.
Effects of two years of growth hormone (GH)
replacement therapy on bone metabolism and
mineral density in childhood and adulthood
onset GH deficient patients.
The data in
this study, drawn from a large population of
hypopituitary adults treated with GH for a
total of more than 800 patient years,
confirm previous reports that untreated GHD
in hypopituitary adults is associated with a
number of important clinical problems.
The data from
this study highlight the value of large
longitudinal surveillance databases in
defining the optimum dose regimen for GH
replacement and indicate that women may need
a higher replacement dose of GH than men.
In this
study, GH therapy resulted in increased
insulin resistance during hypoglycemia,
without changes in the counterregulatory
hormonal responses, serum IGFBP-1, or serum
FFA. The Immune-Endocrine Loop During Aging: Role of Growth Hormone and Insulin-Like Growth Factor-I.pdf
This study
demonstrated that IGF-I prevents apoptosis
in promyeloid cells, which subsequently
permits these cells to differentiate into
neutrophils. It also demonstrated that IL-4
acts much like IGF-I to promote survival of
promyeloid cells and to activate the enzyme
phosphatidylinositol 3'-kinase (PI
3-kinase).
This study
concludes that chronic excess of GH and IGF-I
cause prostate overgrowth and further
phenomena of rearrangement, but not prostate
cancer.
This study
concluded that a significant reduction of
BMD associated with abnormalities of bone
turnover parameters was found only in
patients with very severe or severe GHD,
whereas normal BMD values were found in non-GHD
hypopituitary patients. These abnormalities
were consistently present in all patients
with GHD regardless of the presence of
additional hormone deficits, suggesting that
GHD plays a central role in the development
of osteopenia in hypopituitary patients.
According to
this study, in contrast to virtually all
aspects of metabolism, QOL is difficult to
measure. Only recently have tests been
developed to assess general QOL, whereas
specific tests address those aspects of QOL
affected only in specific situations or
disease states. Hypothalamo-Pituitary-Adrenal Axis and Growth Hormone Axis in Patients with Rheumatoid Arthritis.pdf
The findings
of this study indicate that there is an
impairment in HPA and GH axis in patients
with active and remitted RA. The site of
this impairment is probably hypothalamus
and/or pituitary gland.
The data from
this study show that patients with FM
exhibited a marked decrease in spontaneous
GH secretion, but normal pituitary
responsiveness to exogenously administered
GHRH, thus suggesting the existence of an
alteration at the hypothalamic level in the
neuroendocrine control of GH in these
patients. Furthermore, our finding of
increased IGF-1 and IGFBP-3 levels after GH
treatment, over 4 days, opens up the
possibility of testing the therapeutic
potential of hGH in patients with FM.
The aim of
this study was to evaluate bone metabolism
and mass before and after 2 years of GH
replacement therapy in adults with childhood
or adulthood onset GH deficiency. It
concluded that patients with childhood or
adulthood onset GH deficiency have
osteopenia that can be improved by long-term
treatment with GH. Hormones and Hair Patterning in Men: A Role for Insulin-Like Growth Factor 1?.pdf
Fifty-one men
over age sixty-five participated in this
study. It concludes that testosterone, sex
hormone-binding globulin and IGF-1 may be
important in determining hair patterning in
men. Insulin-Like Growth Factor 1 and Hair Growth.pdf
This article
discusses that Insulin-like growth factor 1
(IGF-1) has been identified as an important
growth factor in many biological systems and
how IGF-1 may be able to stimulate the
proliferation of hair follicle cells through
cellular signaling pathways of its
receptors.
This study
concluded that GH treatment in GH-deficient
adults increased BMD for up to 30-36 months,
with a plateau thereafter. Concurrently with
the plateau in BMD the bone turnover rate
normalized. From the skeletal point of view
GH-deficient patients exhibiting osteopenia
or osteoporosis should be considered as
candidates for GH supplementation of at
least 3-4 years.
Based on the
increasing body of evidence that adults with
GH deficiency (somatotropin
deficiency) have impaired health that
improves with GH replacement,
many countries have already approved
the use of GH for replacement
therapy in adults with GH deficiency.
To ensure that patients are
appropriately identified and treated,
the Growth Hormone Research
Society (GRS) convened a workshop on
April 14–17, 1997, in Port
Stephens, Australia, to formulate consensus
guidelines for the diagnosis
and treatment of adults with GH deficiency. Growth Hormone Deficiency in Adulthood and the Effects of Growth Hormone Replacement: A Review.pdf
The
importance of GH throughout adult life is
now unequivocally accepted.
GH deficiency is recognized to
result in alterations in body composition,
physical performance,
psychological well-being, and substrate
metabolism. Many of these
alterations can be improved or corrected
with GH replacement. The
prospect of GH replacement becoming routine,
however, does raise a number of issues.
This study
concluded that GH replacement therapy in
adult patients with GHD over a period of 18
months causes a pronounced increase in bone
turnover mainly during the first 12 months
of therapy and increases BMD of the lumbar
spine and the femoral neck after 18 months.
The effects
of a combination of mild exercise and GH
injections on bone were studied in old
female rats. This study showed that GH
injections and mild excercise in combination
modulate and increase further the formation
and strength of cortical bone in old female
rats. Effect of Growth Hormone Therapy in Burn Patients on Conservative Treatment.pdf
This study
observed thirteen patients with second and
third degree burns who received recombinant
human growth hormone (rhGH) for two weeks in
addition to standard conservative treatment
and nine patients who were managed with
standard conservative treatment only. The
observations suggest significant benefits of
short term rhGH treatment in burn patients
on conservative management. Two Years of Replacement Therapy in Adults with Growth Hormone Deficiency.pdf
A large group
of human growth hormone (hGH) deficient
adults received human growth hormone (hGH)
replacement therapy for two years. The
study confirmed that human growth hormone (hGH)
supplementation and modulation created
beneficial effects on body composition,
metabolic parameters and improvement on a
general sense of well-being. No Evidence for Involvement of the Growth Hormone/Insulin-Like Growth Factor-1 Axis in Psoriasis.pdf
Psoriasis
patients took part in this study to
determine whether altering the growth
hormone/insulin-like growth factor-1 axis
plays a role in the pathogenesis of
psoriasis.
This study
included forty-six adult men with
childhood-onset of growth hormone
deficiency. Twenty-five of the participants
were androgen-deficient and received
replacement. The conclusion of the study
was that for growth hormone-deficient men,
growth hormone substitution therapy has an
auxiliary effect on androgen action in the
skin without an increase of the free
androgen index. A Preliminary Study of Growth Hormone in the Treatment of Dilated Cardiomyopathy.pdf
This study
concludes that recombinant human growth
hormone administered for three months to
patients with idiopathic dilated
cardiomyopathy increased myocardial mass and
reduced the size of the left ventricular
chamber, resulting in improvement in
hemodynamics, myocardial energy metabolism,
and clinical status.
In this
study, all parameters (except IGF1) did not
show any variation during and after rhGH
treatment at low doses. The alterations of
T3 and T4 metabolism, in the sense of a T3
increase and a T4 reduction, caused
sometimes by rhGH treatment, could be due to
the higher doses used and therefore should
be considered another side effect, like
artrhalgia, fluid retention, carpal tunnel
syndrome, etc.
According to
this study, growth hormone administered to
men with adult-onset growth hormone
deficiency at a dose adjusted according to
serum IGF-1 levels increases bone density
and stimulates bone turnover, decreases body
fat and increases lean mass, and is
associated with a low incidence of side
effects. Insulin-Like Growth Factor-I (Somatomedin C) Levels in Chronic Fatigue Syndrome and Fibromyalgia.pdf
These
findings of this study suggest the
disruption of the growth hormone-IGF-I axis
previously demonstrated in FM patients is
not evident in a referral population of
patients with CFS, CFS-FM, or FM.
This study
concluded that patients with active RA, even
in the early phases, lose bone very rapidly.
Effective control of systemic inflammation
allowed a rapid rescue of BMD, at least in
the short term. This happened with a
simultaneous increase in some anabolic
variables such as IGF-1, BGP, and DHEAS. Growth Hormone Therapy for Protein Catabolism.pdf
GH and IGF-1
have shown remarkable consistency of effect
in a wide range of catabolic conditions,
including improved net protein synthesis and
preserving lean body mass.
According to
this study, two years of GH treatment
induced a sustained increase in overall bone
remodeling activity, which resulted in a net
gain in BMD that was more marked in those
subjects with a low pretreatment z-score.
The purpose
of this study was to prove whether
stimulating collagen type I synthesis would
be accompanied by a deposition of collagen
type I in the skin. It examined twenty
growth hormone-deficient hypopituitary
patients for twelve months.
Computed
tomography was used to examine the short and
long-term effects of recombinant human
growth hormone (rhGH) on body composition
and regional tissue distributions in this
two-part study. Its findings look at
Adipose tissue, muscle and visceral organs. Anterior Pituitary Function in Patients with Newly Diagnosed Rheumatoid Arthritis.pdf
In this
study, a combined test for total anterior
pituitary reserve was performed in 10
patients with newly diagnosed untreated RA.
Before and after stimulation with the
respective hypothalamic releasing hormones,
RA patients showed no difference in plasma
concentrations of adrenocorticotrophic
hormone (ACTH), cortisol, prolactin (PRL)
and thyroid-stimulating hormone (TSH) when
compared to healthy controls.
This study
concluded that the effects of CysA on IGF-I
may explain some of the clinical,
immunologic, and metabolic results during
CysA treatment of rheumatic diseases.
This article
discusses a study of ten massively burned
patients with full-thickness burns covering
more than 40% of total body surface area.
It examined the efficacy of recombinant
human growth hormone (rhGH) on burn patients
for wound healing.
According to
this study, growth hormone deficiency (GHD)
in adults is now recognized as a specific
clinical syndrome with characteristic
symptoms and signs. Thus, the patients are
overweight, have an abnormal body
composition (excess body fat and a decrease
in the extracellular water volume) and a low
bone mineral content compared to normals.
Adult
patients with human growth hormone (hGH)
deficiency are thought to be at a higher
risk of cardiovascular disease. This study
concludes that human growth hormone (hGH)
supplementation and modulation of adult
human growth hormone (hGH) deficient
patients is associated with beneficial
changes in lipid and lipoprotein profiles.
Advances in Recombinant Human Growth Hormone Replacement Therapy in Adults.pdf
According to
this article, it is now apparent that
acquired GH deficiency is associated with
significant changes in body composition,
bone density, lipid metabolism,
cardiovascular function and physical
performance. In addition, new information is
now available on the use of low doses of
recombinant human growth hormone (rhGH) to
reverse the negative effects of GH
deficiency in adults.
This study
investigated the potential pituitary origin
of gonadal insufficiency in hemochromatosis.
Gonadotropin secretion was studied in seven
patients with hemochromatosis and
hypogonadism, before and after chronic
pulsatile GnRH therapy. It was concluded
that hypogonadism in hemochromatosis is due
to pituitary lesions.
This study
examined endocrine functions at baseline and
after TRH and LHRH stimulation in a group of
7 young male patients with genetic
hemochromatosis (HE) without liver damage
(i.e. fibrosis and cirrhosis). In five
patients endocrine re-evaluations after
complete iron depletion was also performed.
Effects of Human Growth Hormone in Men Over
60 Years Old.pdf Beneficial Effects of Growth Hormone Treatment in GH-Deficient Adults.pdf
Twenty-two
growth hormone-deficient patients
participated in this study. The finding of
this study suggest that growth hormone, in a
conventional replacement dose, has several
potentially beneficial effects in GH-deficient
adults
In this
study, IGF-1 levels were examined in a man
with hypothalamic growth hormone-deficiency
before and during the first six days of
treatment with daily growth hormone
injections.
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