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The effects of five-year growth hormone replacement therapy on muscle strength in elderly hypopituitary patients.

Artikel i vetenskaplig tidskrift
Författare Galina Götherström
Bengt-Åke Bengtsson
Katharina S Sunnerhagen
Gudmundur Johannsson
Johan Svensson
Publicerad i Clinical endocrinology
Volym 62
Nummer/häfte 1
Sidor 105-13
ISSN 0300-0664
Publiceringsår 2005
Publicerad vid Institutionen för invärtesmedicin
Institutionen för samhällsmedicin, Avdelningen för rehabiliteringsmedicin
Sidor 105-13
Språk en
Länkar dx.doi.org/10.1111/j.1365-2265.2004...
Ämnesord Aged, Analysis of Variance, Body Composition, Densitometry, X-Ray, Female, Growth Hormone, deficiency, Hand Strength, Humans, Hypopituitarism, blood, drug therapy, physiopathology, Insulin-Like Growth Factor I, analysis, Knee Joint, Male, Middle Aged, Muscle Contraction, drug effects, Muscle, Skeletal, physiopathology, Prospective Studies, Tensile Strength, drug effects, Time Factors, Treatment Outcome
Ämneskategorier Endokrinologi

Sammanfattning

OBJECTIVE: Little is known of the long-term effects of GH replacement therapy on muscle strength in elderly adults with adult onset GH deficiency (GHD). In this study, the effects of 5 years of GH replacement therapy on muscle function were determined in adults over 60 years of age with adult onset GHD. DESIGN: A prospective, open-label, single-centre study. Patients Twenty-six (12 male and 14 female) consecutive hypopituitary adults with adult onset GHD, mean age 65.0 (range 61-74) years. MEASUREMENTS: Upper leg muscle strength was measured using a Kin-Com dynamometer. Right and left handgrip strength were measured using an electronic grip force instrument. RESULTS: The mean insulin-like growth factor-I (IGF-I) SD score increased from -1.10 at baseline to 1.21 at end of the study. Body weight was unchanged during the 5-year study. A sustained increase in lean body mass and a sustained reduction of body fat was observed as measured using dual-energy X-ray absorptiometry (DEXA). The GH replacement therapy induced a sustained increase in isometric (60 degrees ) knee flexor strength. After statistical correction for age and sex variables using observed/predicted value ratios, a sustained increase was also observed in concentric knee flexor strength at an angular velocity of 60 degrees /s, concentric knee extensor strength at 60 degrees /s and 180 degrees /s, and peak right handgrip strength. At baseline, knee flexor strength was 90-96% of predicted, knee extensor strength was 85-87% of predicted, and hand-grip strength was 74-80% of predicted values. At study end, knee flexor strength was 98-106% of predicted, knee extensor strength was 90-100% of predicted, and hand-grip strength was 80-87% of predicted values. CONCLUSION: Elderly patients with adult onset GH deficiency had decreased baseline muscle strength also after correction for age and sex. The 5-year GH replacement therapy normalized knee flexor strength and improved, but did not fully normalize, knee extensor strength and handgrip strength.

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