GROWTH HORMONE AND/OR EXERCISE FOR THE FRAIL ELDERLY

老年人进行性虚弱是跌倒的主要原因，与 分裂、社会孤立，最终导致制度化或死亡。 肌肉无力是导致全身虚弱的主要原因之一。贡献于 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。这项研究将检验生长激素 管理和运动训练可以协同作用来改善肌肉 在老年人中的表现；它还将检验以下子假说 在正式演习结束后继续进行生长激素管理 该计划将延长该运动训练的好处。其影响 重组人生长激素(RhGH)，一种等张运动计划， 或者两者结合，将在老年人口中确定 预选的体能低于平均水平。男性和女性 受试者(240人)将在3个老年人所在的社区招募 罗德岛的中心，随机接受rhGH，rhGH加 运动训练、安慰剂加运动或单独服用安慰剂。生长激素(0.015毫克/公斤 《南卡罗来纳州日报》)将进行为期一年的运动训练 在6个月的65次会议期间，在3个老年中心进行监督， 6个月后继续服用生长激素或安慰剂。研究对象将 通过标准化的体能测试进行评估；对于肌肉 使用等速测力法的力量；局部和全身倾斜和 双X线法测定脂肪软组织质量和骨矿含量 密度测量；静息卡路里消耗；生化和激素 指标包括IGF-I及其结合蛋白。辅助性研究将 包括在评估形态和结构受试者子集中进行肌肉活检 IGF-I及其受体的表达。使用一种新型的机械刺激 肌细胞培养系统，促进肌肉生长的生物测定 受试者的血清和肌肉提取液将在静态和静态条件下进行比较 刺激条件。最后，使用经过验证的调查工具 体力活动和健康结果和利用，这项研究可能表明 这一联合干预计划在减少儿童死亡率方面确实有效 老年人进行性虚弱造成的人类和社会经济损失。

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.