Giannoulis Manthos G, Sonksen Peter H, Umpleby Margot, Breen Louise, Pentecost Claire, Whyte Martin, McMillan Carolyn V, Bradley Clare, Martin Finbarr C
Department of Diabetes and Endocrinology, GKT School of Medicine, King's College London, St. Thomas' Hospital, London SE1 7EH, UK.
J Clin Endocrinol Metab. 2006 Feb;91(2):477-84. doi: 10.1210/jc.2005-0957. Epub 2005 Dec 6.
Declines in GH and testosterone (Te) secretion may contribute to the detrimental aging changes of elderly men.
To assess the effects of near-physiological GH with/without Te administration on lean body mass, total body fat, midthigh muscle cross-section area, muscle strength, aerobic capacity, condition-specific quality of life (Age-Related Hormone Deficiency-Dependent Quality of Life questionnaire), and generic health status (36-Item Short-Form Health Survey) of older men.
DESIGN, SETTINGS, AND PARTICIPANTS: A 6-month, randomized, double-blind, placebo-controlled trial was performed on 80 healthy, community-dwelling, older men (age, 65-80 yr).
Participants were randomized to receive 1) placebo GH or placebo Te, 2) recombinant human GH (rhGH) and placebo Te (GH), 3) Te and placebo rhGH (Te), or 4) rhGH and Te (GHTe). GH doses were titrated over 8 wk to produce IGF-I levels in the upper half of the age-specific reference range. A fixed dose of Te (5 mg) was given by transdermal patches.
Lean body mass increased with GHTe (P = 0.008) and GH (P = 0.004), compared with placebo. Total body fat decreased with GHTe only (P = 0.02). Midthigh muscle (P = 0.006) and aerobic capacity (P < 0.001) increased only after GHTe. Muscle strength changes were variable; one of six measures significantly increased with GHTe. Significant treatment group by time interactions indicated an improved Age-Related Hormone Deficiency-Dependent Quality of Life questionnaire score (P = 0.007) in the GH and GHTe groups. Bodily pain increased with GH alone, as determined by the Short-Form Health Survey (P = 0.003). There were no major adverse effects.
Coadministration of low dose GH with Te resulted in beneficial changes being observed more often than with either GH or Te alone.
生长激素(GH)和睾酮(Te)分泌的减少可能导致老年男性出现有害的衰老变化。
评估接近生理剂量的GH联合或不联合Te给药对老年男性瘦体重、全身脂肪、大腿中部肌肉横截面积、肌肉力量、有氧运动能力、特定疾病生活质量(年龄相关激素缺乏相关生活质量问卷)和一般健康状况(36项简短健康调查)的影响。
设计、地点和参与者:对80名健康的社区居住老年男性(年龄65 - 80岁)进行了一项为期6个月的随机、双盲、安慰剂对照试验。
参与者被随机分为接受1)安慰剂GH或安慰剂Te,2)重组人生长激素(rhGH)和安慰剂Te(GH组),3)Te和安慰剂rhGH(Te组),或4)rhGH和Te(GHTe组)。GH剂量在8周内进行滴定,以使胰岛素样生长因子-I(IGF-I)水平处于年龄特异性参考范围的上半部分。通过透皮贴剂给予固定剂量的Te(5毫克)。
与安慰剂相比,GHTe组(P = 0.008)和GH组(P = 0.004)的瘦体重增加。仅GHTe组的全身脂肪减少(P = 0.02)。仅在GHTe组后大腿中部肌肉(P = 0.006)和有氧运动能力(P < 0.001)增加。肌肉力量变化不一;六项测量指标中的一项在GHTe组显著增加。治疗组与时间的显著交互作用表明,GH组和GHTe组的年龄相关激素缺乏相关生活质量问卷评分有所改善(P = 0.007)。根据简短健康调查,仅GH组身体疼痛增加(P = 0.003)。没有重大不良反应。
低剂量GH与Te联合给药比单独使用GH或Te更常观察到有益变化。