Use of Growth Hormone for Treatment of Anatomic and Physiologic Decrements Associated with Aging

Summary: Effects of growth hormone on cardiovascular health and its periphery. Not much there.

Interestingness: 1

Paper by Bengt-Åke Bengtsson, Gudmundur Johannsson, and Jörgen Isgaard, all of them MD, PhD, in the Journal of Anti-Aging Medicine, Volume 1, Issue 3, Fall 1998.

Case studies show improvements in heart function in heart failure patients when given growth hormone (GH). Placebo-controlled studies fail to replicate those effects. In rats, insulin-like growth factor 1 (IGF-1) lowers heart cell apopstosis after induced heart attacks.

Like in the previous paper summarised, they note the similarities between GH deficiency and Syndrome X (insulin resistance plus hypertension) (abdomen/visceral obesity, insulin resistance, high triglycerides, low levels of high density lipoprotein (HDL), hypertension, high plasma fibrinogen, high plasminogen activator inhibitor (PAI-1) activity, premature atherosclerosis and high cardiovascular disease mortality), and also the association between higher abdominal/visceral fat and lower secretions of GH and subsequent IGF-1. In some trials, massive weight loss restores normal levels of GH secretion, but in others it doesn't.

In GH-deficient people, GH supplementation does lots of good things (lower visceral fat, lower diastolic blod pressure, total cholesterol, and low density lipoprotein (LDL), and raises HDL).

In GH sufficient people, it doesn't help the obese lose weight, but in a nine-month study by the authors on obese men, it lowered total body fat, abdominal fat, total cholesterol, triglycerides, it improved insulin sensitivity and lowered diastolic blood pressure, but plasma fibrinogen levels increased. Hypothesis given for the effects are:

• Higher insulin sensitivity: lower fatty-acid exposure by the liver through lower abdominal fat. Or increased glucose transport by the skeletal muscles
• Lower total cholesterol: more liver LDL-receptors
• Lower triglycerides: increased insulin-stimulated glucose uptake
• Lower diastolic blood pressure: reduced peripheral vascular resistance through increased insulin-sensitivity or through IGF-1 action on the vascular wall with increased levels of nitric oxide.
  

Concludes with a section about end-stage renal failure patients and a 6-month study by the authors showing increased muscle mass and strength, and increased albumin concentration in these patients when given a low dose of GH.



Abstract follows:

There are striking similarities between Syndrome X or "the metabolic syndrome" and untreated GH deficiency in adults. The most central findings in both these syndromes are abdominal/visceral obesity and insulin resistance. Other features common to both syndromes are lipid abnormalities, increased prevalence of hypertension, elevated levels of plasma fibrinogen and plasminogen activator inhibitor (PAI)-l activity, premature atherosclerosis, and increased mortality from cardiovascular disease. GH treatment can improve several of the aberrations that GH deficiency has in common with Syndrome X. Recently, we have shown that nine months of treatment in a randomized, double-blind, placebo-controlled trial in middle-aged men with abdominal/visceral obesity reduced their total body fat and resulted in specific and marked decrease in both abdominal subcutaneous and visceral adipose tissue. Moreover, insulin sensitivity and lipoprotein profile improved, and diastolic blood pressure decreased.

A number of experimental and clinical studies suggest a potential role for GH as an addition to conventional therapy for the treatment of congestive heart failure (CHF). Recently, patients with heart failure due to idiopathic dilated cardiomyopathy showed a positive response to GH addition. However, so far, no placebo-controlled study with GH addition to standard optimal therapy in patients with CHF has been able to confirm these findings. Elderly patients on chronic hemodialysis are in a chronic catabolic phase with low lean body mass. We have recently performed a randomized double-blind placebo-controlled trial with GH in elderly on chronic dialysis. Six months of treatment improved lean body mass, muscle strength and walking capacity.