AIM: To assess efficacy of GH replacement and safety of stopping treatment in patients aged over 60 years.
METHODS: GH-deficient patients were started on GH 0.13 miligram per day and the dose titrated over 4 months to a serum IGF-1 in the upper half of the age-related normal range. After 4 months titration, patients were randomised to either continuing GH or placebo in a double-blind, cross-over study with 2 x 4 month periods of either GH or placebo treatment.
RESULTS: 14 patients (9 men) completed the study; median (range) age 69.5 (63-77) years, and GH dose 0.27 (0.13-0.8) miligram daily. Where no period effect existed results for patients are grouped together as either GH or placebo phase. Mean plus/minus SEM truncal fat mass decreased from 15.9 plus/minus 1.2 kilogram to 14.5 plus/minus 1.0 kilogram during 4 months titration (p=0.002), there was no further change during the GH phase but truncal fat increased during placebo treatment (p=0.014). Total lean mass increased from 48.1 plus/minus 2.2 kilogram to 49.7 plus/minus 2.4 kilogram (p=0.002) at 4 months, remained the same during GH and decreased to 48.4 plus/minus 2.3 kilogram during placebo (p=0.0003). Serum osteocalcin increased from 21.9 plus/minus 2.7 microgram per litre to 27.4 plus/minus 3.2 microgram per litre (p=0.045) at 4 months, remained elevated at 31.6 plus/minus 4.2 microgram per litre during GH and fell to 22.6 plus/minus 3.3 microgram per litre during placebo (p=0.012). QOL (AGHDA) improved in the 7 patients going from placebo to GH, 11 plus/minus 3 to 7 plus/minus 2 (p=0.017).
CONCLUSIONS: In older GH deficient patients GH treatment reduced truncal fat, increased lean body mass and increased bone turnover. These effects reversed on stopping GH therapy.
24 - 26 Mar 2003
British Endocrine Societies