Zachwieja J J, Yarasheski K E
Exercise and Nutrition Program, Pennington Biomedical Research Center, Baton Rouge, La., USA.
Phys Ther. 1999 Jan;79(1):76-82.
Improved muscle protein mass and increments in maximum voluntary muscle force have rarely been observed in men and women aged 60 years and older who were treated with rhGH. Although rhGH administration has been reported to increase lean body mass in older men and women, it is doubtful that this increase is localized to skeletal muscle contractile proteins. When rhGH administration was combined with 16 weeks of resistance exercises, increases in muscle mass, muscle protein synthesis, and muscle force were not greater in the rhGH-treated group than in a weight training group that received placebo injections. Side effects of rhGH treatment in elderly people are prevalent, not trivial, and further limit its usefulness as an effective anabolic agent for promoting muscle protein accretion in men and women. In particular, the induction of insulin resistance and carpal tunnel compression reduces the efficacy of rhGH replacement therapy in elderly individuals. The evidence for a GH-induced increase in human skeletal muscle protein and maximum voluntary muscle force is weak. The optimum dose and GH-replacement paradigm (GHRH, GH-secretagogues) have not been identified. Whether rhGH therapy improves muscle protein mass and force in individuals with severe cachexia associated with major trauma, burns, surgery, or muscular dystrophy is controversial and under investigation.
接受重组人生长激素（rhGH）治疗的60岁及以上男性和女性，很少观察到肌肉蛋白量增加以及最大随意肌力增强。尽管有报道称，rhGH给药可增加老年男性和女性的瘦体重，但这种增加是否局限于骨骼肌收缩蛋白仍值得怀疑。当rhGH给药与16周的抗阻运动相结合时，rhGH治疗组的肌肉量、肌肉蛋白合成和肌力增加并不比接受安慰剂注射的重量训练组更大。rhGH治疗老年人的副作用很常见，并非微不足道，这进一步限制了其作为促进男性和女性肌肉蛋白积累的有效合成代谢剂的用途。特别是，胰岛素抵抗的诱导和腕管压迫降低了rhGH替代疗法在老年人中的疗效。关于生长激素诱导人体骨骼肌蛋白和最大随意肌力增加的证据不足。尚未确定最佳剂量和生长激素替代模式（生长激素释放激素、生长激素促分泌素）。rhGH疗法是否能改善与重大创伤、烧伤、手术或肌肉萎缩症相关的严重恶病质患者的肌肉蛋白量和肌力，仍存在争议且正在研究中。
