EMILIANO CORPAS*,
S. MITCHELL HARMAN and
MARC R. BLACKMAN
Endocrinology Section, Francis Scott Key Medical Center and Johns Hopkins University School of Medicine Baltimore, Maryland 21224
Laboratory of Clinical Physiology, Gerontology Research Center, National Institute on Aging, National Institutes of Health, University School of Medicine, and the Departments of Medicine Francis Scott Key Medical Center and Johns Hopkins University School of Medicine Baltimore, Maryland 21224
Correspondence: Address requests for reprints to: S. Mitchell Harman, M.D., Ph.D, Gerontology Research Center, Room 2B19, 4940 Eastern Avenue, Baltimore, Maryland 21224.
Abstract
I. Introduction: UNTIL recently, there has been little scientific inquiry intothe physiological significance of, and possible therapy for,GH deficiency in adulthood. This was because the lack of efficacyin humans of animal-derived (e.g.1 bovine or porcine) GH andthe limited supply of human cadaveric GH restricted use of exogenousGH to treatment of GHdeficient children. The availability ofrecombinant human GH (rhGH) has led to a renewal of scientificand clinical interest in investigating wider indications forGH administration. It is now recognized that GH deficiency mayexert adverse metabolic effects in adults with panhypopituitarism,and that these effects can be reversed or attenuated by treatmentwith rhGH (1, 2). Recently, it has also become apparent that,with advancing age, an increasing proportion of men and womenwith no clinical evidence of pituitary pathology show decreasesin GH secretion and serum levels of insulin-like growth factor-I(IGF-I) (3, 4). Because GH deficiency (1, 2) and normal aging(5) are both associated with decreases in protein synthesisand percent of lean body and bone mass, and with increases inpercent of body fat, it is possible that reduced GH secretionand IGF-I levels might account, at least in part, for one ormore of the above effects of aging, and that some older peoplemight benefit from treatment with rhGH. In this regard, in severalrecent studies, administration of rhGH for periods varying froma few weeks to 6 months has resulted in improvements in nitrogenbalance, an increase in lean body mass, and a decrease in percentbody fat in older persons with low IGF-I levels (3, 4, 6, 7).We review herein the published work describing the alterationsin GH and IGF-I production with increasing age, and the methods,benefits, and risks of GH treatment of older persons in thelight of new knowledge regarding basic physiology of GH secretionand action. We also attempt to point out areas requiring furtherinvestigations.
Footnotes
* Recipient of Grant 89/1030 from Ministerio de Sanidad y Consumo,Fondo de Investigaciones Sanitarias and Hospital General Universitariode Guadalajara, Spain. Current address: Merck Sharpe & DomeEspafia, Josefa Valcarcel 38, 28027 Madrid-Spain.
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P. Sytze van Dam, H. E. C. Smid, W. R. de Vries, M. Niesink, E. Bolscher, E. J. Waasdorp, C. Dieguez, F. F. Casanueva, and H. P. F. Koppeschaar Reduction of Free Fatty Acids By Acipimox Enhances the Growth Hormone (GH) Responses to GH-Releasing Peptide 2 in Elderly Men
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L. Gianotti, M. Maccario, F. Lanfranco, J. Ramunni, L. Di Vito, S. Grottoli, E. E. Muller, E. Ghigo, and E. Arvat Arginine Counteracts the Inhibitory Effect of Recombinant Human Insulin-Like Growth Factor I on the Somatotroph Responsiveness to Growth Hormone-Releasing Hormone in Humans
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K. Dorshkind and N. D. Horseman The Roles of Prolactin, Growth Hormone, Insulin-Like Growth Factor-I, and Thyroid Hormones in Lymphocyte Development and Function: Insights from Genetic Models of Hormone and Hormone Receptor Deficiency
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