Exp Clin Endocrinol Diabetes 2007; 115 - P02_081
DOI: 10.1055/s-2007-972488

No age related benefit of growth hormone replacement in adults

E Spilcke-Liss 1, K Möller 1, M Buchfelder 2, W Fassbender 3, M Faust 4, P Kann 5, I Kreitschmann-Andermahr 6, U Tuschy 7 H Wallaschofski 1, on behalf of the German KIMS Board
  • 1University of Greifswald, Department of Gastroenterology, Endocrinology and Nutrition, Greifswald, Germany
  • 2University of Erlangen, Department of Neurosurgery, Erlangen, Germany
  • 3Department of Internal Medicine Kempten, Kempten, Germany
  • 4University of Cologne, Department of Endocrinology, Cologne, Germany
  • 5University of Marburg, Department of Endocrinology, Marburg, Germany
  • 6University of Aachen, Department of Neurosurgery, Aachen, Germany
  • 7Department of Internal Medicine Erfurt, Erfurt, Germany

The effects of growth hormone (GH) replacement in elderly GH deficient (GHD) adults are not well known. Therefore we analysed the German KIMS database to compare the effects of a two year GH replacement therapy considering the age of patients. The analysis was performed by using data of 1,431 consecutively recruited patients (779 men and 652 women) with GHD aged 20 to 79 (median 44.95) years. All patients had severe GHD (peak GH response <3µg/l in ITT and/or peak GH response <9µg/l in arginine-GHRH-test) and were assigned to age related groups. The patients received a low starting dose of GH (0.1–0.3mg/day) that was adjusted individually. The mean daily doses of GH were 0.31±0.13mg/d after 6 months of treatment, and 0.29±0.15mg/d after 12 months of treatment. Most of the patients received additional hormone replacement therapy and were on optimal doses at recruitment. Patients were examined for body mass index (BMI), serum IGF-1, fasting lipid profile (triglyceride, LDL-cholesterol and HDL-cholesterol), blood pressure, heart rate and QoL-AGHDA score at baseline and two years after starting growth hormone replacement therapy.

The IGF-1 and IGF-1 SDS-levels increased in all patient groups significantly. We detected a significant decrease in LDL-cholesterol in all groups except for the group of 70–79y (3.9 vs. 3.2 mmol/l, p=0.06). GH replacement showed no significant changes in triglycerides (1.9 vs. 1.8 mmol/l; p=0.66) or in HDL-cholesterol. The systolic or diastolic blood pressure (125 vs. 130mmHg; p=0.91 or 80 vs. 80mmHg; p=0.12) as well as the heart rate (72 vs. 72 b/min; p=0.05) remained unaffected. Blood glucose levels increased in the groups 30–39 and 40–49 only, without clinical impairment of glucose metabolism (4.4 vs. 4.5 and 4.5 vs. 4.7 mmol/l p=0.001). The QoL-AGHDA score improved in all groups significantly (8 vs. 4; p<0.01).

In elderly GHD adults a low dose of GH can improve serum lipid profile without significant impairment of glucose metabolism and improve QoL. Therefore GH replacement should be considered in elderly GHD adults.