Growth hormone replacement in healthy older men improves body composition but not functional ability
Growth hormone replacement in healthy older men improves body composition but not functional ability
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DOI：
10.7326/0003-4819-124-8-199604150-00002
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发表时间：
1996-04-15
影响因子：
39.2
通讯作者：
Grunfeld, C
中科院分区：
文献类型：
--
作者：
Papadakis, MA;Grady, D;Grunfeld, C
目的：确定生长激素替代治疗是否能改善老年男性的功能。设计：随机、对照、双盲试验。设置：一般社区。患者：52名69岁以上的健康男性，功能保持良好，但基线胰岛素样生长因子1水平较低。干预：生长激素（0.03毫克/公斤体重）或安慰剂每周给药三次，持续6个月。测量：身体成分，膝盖和手握肌肉力量，全身耐力和认知功能。结果：参与者的平均年龄为75.0岁（范围为70至85岁）。在6个月时，生长激素组的瘦体重平均增加了4.3%，安慰剂组减少了0.1%，差异为4.4个百分点（95%CI，2.1至6.8个百分点）。生长激素组的脂肪量平均减少了13.1%，安慰剂组减少了0.3%，差异为12.8个百分点（CI，8.6至17.0个百分点）。两组之间在膝关节或手握力或全身耐力方面没有观察到统计学或临床显著差异。生长激素组的Trails B平均得分提高了8.5秒，而安慰剂组的得分下降了5.0秒，相差13.5秒（C1，3.1秒至23.9秒; P = 0.01）然而，生长激素组的简易精神状态检查评分下降了0.4，而安慰剂组的评分提高了0.2，差异为0.6（P = 0.11）。两组数字符号替代测验成绩基本相同（P > 0.2）。生长激素组的26名男性有48起副作用，26名安慰剂接受者有14起副作用（P = 0.002）。26%的生长激素接受者需要减少剂量，而安慰剂接受者没有需要减少剂量（P < 0.001）。结论：对功能能力保存良好的健康老年男性给予生理剂量的生长激素6个月，可增加瘦组织质量，减少脂肪质量。虽然身体成分随着生长激素的使用而改善，但功能能力并没有改善。副作用频繁发生。
Objective: To determine whether growth hormone replacement in older men improves functional ability.Design: Randomized, controlled, double-blind trial.Setting: General community.Patients: 52 healthy men older than 69 years of age with well-preserved functional ability but low baseline insulin-like growth factor 1 levels.Intervention: Growth hormone (0.03 mg/kg of body weight) or placebo given three times a week for 6 months.Measurements: Body composition, knee and hand grip muscle strength, systemic endurance, and cognitive function.Results: The participants' mean age was 75.0 years (range, 70 to 85 years). At 6 months, lean mass had increased on average by 4.3% in the growth hormone group and had decreased by 0.1 % in the placebo group, a difference of 4.4 percentage points (95% CI, 2.1 to 6.8 percentage points). Fat mass decreased by an average of 13.1% in the growth hormone group and by 0.3% in the placebo group, a difference of 12.8 percentage points (CI, 8.6 to 17.0 percentage points). No statistically or clinically significant differences were seen between the groups in knee or hand grip strength or in systemic endurance. The mean Trails B score in the growth hormone group improved by 8.5 seconds, whereas scores in the placebo group deteriorated by 5.0 seconds, a difference of 13.5 seconds (CI, 3.1 seconds to 23.9 seconds; P = 0.01) However, the growth hormone group's score on the Mini-Mental Status Examination deteriorated by 0.4, whereas the placebo group's score improved by 0.2, a difference of 0.6 (P = 0.11). The two treatment groups had almost identical scores on the Digit Symbol Substitution Test (P > 0.2). Twenty-six men in the growth hormone group had 48 incidents of side effects, and 26 placebo recipients had 14 incidents of side effects (P = 0.002). Dose reduction was required in 26% of the growth hormone recipients and in none of the placebo recipients (P < 0.001).Conclusions: Physiologic doses of growth hormone given for 6 months to healthy older men with well-preserved functional abilities increased lean tissue mass and decreased fat mass. Although body composition improved with growth hormone use, functional ability did not improve. Side effects occurred frequently.