GROWTH HORMONE AND/OR EXERCISE FOR THE FRAIL ELDERLY

老年人进行性虚弱是福尔斯的主要原因， 断裂，社会孤立，最终制度化或死亡。 肌肉无力是全身虚弱的一个主要原因。 有助于 这可能是不活动和生长激素分泌减少，已知 随着年龄的增长而发生。 本研究将检验GH 给药和运动训练可以协同改善肌肉 在老年人的表现;它也将测试子假设， 停止正式运动后继续GH给药 该计划将延长该运动训练的益处。 的影响 重组人生长激素（rhGH），等张运动计划， 或两者结合，将在老年人群中确定 低于平均水平的物理性能预选。 男女 受试者（240名）将在3名老年人的社区中招募 罗得岛的研究中心，随机接受rhGH、rhGH + 运动训练、安慰剂加运动或仅安慰剂。 GH（0.015 mg/kg daily，s.c.）将进行为期一年的管理;运动训练将 在6个月的65次会议期间，在3个老年中心进行监督， 随后连续6个月给予GH或安慰剂。 受试者将 用标准化的身体性能测试进行评估;对于肌肉 力量使用等速测力法;区域和全身倾斜， 脂肪软组织质量和骨矿物质含量使用双X线 密度测定;静息热量消耗;生化和激素 包括IGF-I及其结合蛋白。 辅助研究将 包括评估形态学受试者子集中的肌肉活组织检查， IGF-I及其受体表达。 使用一种新的机械刺激 肌细胞培养系统，促进肌肉生长作用的生物测定， 受试者的血清和肌肉提取物将在静态和 刺激的条件。 最后，使用经过验证的调查工具， 这项研究可能表明， 这种联合干预计划在减少艾滋病病毒感染方面具有真实的功效， 老年人进行性虚弱造成的人力和社会经济损失。

Progressive frailty in the elderly is a major cause of falls, associated fractures, social isolation, and ultimately institutionalization or death. Muscle weakness is one major cause of overall frailty. Contributing to this may be inactivity and decreased growth hormone secretion, known to occur with progressive aging. This study will test the hypothesis that GH administration and exercise training may synergize to improve muscle performance in the elderly; it will also test the sub-hypothesis that continued GH administration after discontinuation of a formal exercise program will prolong the benefits of that exercise training. The effects of recombinant human growth hormone (rhGH), an isotonic exercise program, or the two combined, will be determined in an elderly population preselected for below average physical performance. Male and female subjects (240) will be recruited in the neighborhoods of 3 senior citizen centers in Rhode Island and randomized to receive either rhGH, rhGH plus exercise training, placebo plus exercise or placebo alone. GH (0.015 mg/kg daily, s.c.) will be administered for one year; exercise training will be supervised in the 3 senior centers during 65 sessions over 6 months, followed by 6 months continued GH or placebo administration. Subjects will be evaluated with a standardized physical performance test; for muscle strength using isokinetic dynamometry; regional and whole body lean and adipose soft tissue mass and bone mineral content using dual X-ray densitometry; resting caloric expenditure; and biochemical and hormonal indices including IGF-I and its binding proteins. Ancillary studies will include muscle biopsies in a subset of subjects evaluating morphology and IGF-I and its receptor expression. Using a novel mechanically stimulated myocyte culture system, bioassay of muscle growth promoting effects of subjects' sera and muscle extract will be compared under static and stimulated conditions. Finally, using validated survey instruments of physical activity and health outcomes and utilization, this study may show that this combined intervention program has real efficacy in reducing the human and socioeconomic toll of progressive frailty in the elderly.