Abstract
When a deficiency of growth hormone (GH) or testosterone occurs in men during early or mid-adulthood, hormone replacement is an important consideration. Because of its favorable anabolic, hematopoietic, androgenic, and antiosteopenic effects, there is usually little question that testosterone should be prescribed. Treatment with human GH (hGH), a more expensive and only recently available medication, is now also being advocated by some endocrinologists because of its beneficial actions on body composition, work capacity, and quality of life (1-5).
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Degerblad M, Almkvist O, Grunditz R, et al. Physical and psychological capabilities during substitution therapy with recombinant growth hormone in adults with growth hormone deficiency. Acta Endocrinol (Copenh) 1990; 123:185–93.
Jorgensen JOL, Pedersen SA, Thuesen L, et al. Beneficial effects of growth hormone treatment in GH-deficient adults. Lancet 1989;1:1221–5.
Lamberts SWJ, Valk NK, Binnerts A. The use of growth hormone in adults: a changing scene. Clin Endocrinol 1992;37:111–5.
Hager A. Should adults with growth hormone deficiency be maintained on growth hormone substitution therapy? Acta Paediatr Scand (Suppl) 1989; 362:72–5.
Salomon F, Cuneo RC, Hesp R, et al. The effects of treatment with recombinant human growth hormone on body composition and metabolism in adults with growth hormone deficiency. N Engl J Med 1989;321:1797–803.
Harman SM, Blackman MR. Growth hormone, IGF-I, gonadal steroids, and aging. Aging Clin Exp Res 1992;4:257–9.
Corpas E, Harman SM, Blackman MR. Human growth hormone and human aging. Endocr Rev 1993;14:20–39.
Abbasi AA, Drinka PJ, Mattson DE, et al. Low circulating levels of insulin-like growth factors and testosterone in chronically institutionalized elderly men. J Am Geriatr Soc 1993;41:975–82.
Korenman SG, Morley JE, Mooradian AD, et al. Secondary hypogonadism in older men: its relation to impotence. J Clin Endocrinol Metab 1990;71: 963–9.
Rudman D. Growth hormone, body composition and aging. J Am Geriatr Soc 1985;33:800.
Roubenoff R, Rall LC. Humoral mediation of changing body composition during aging and chronic inflammation. Nutr Rev 1993;51:1–11.
Kelijman M. Age related alterations of the growth hormone/insulin-like growth factor I axis. J Am Geriatr Soc 1991;39:295–307.
Hartman ML, Faria ACS, Vance ML, et al. Temporal structure of in vivo growth hormone secretory events in humans. Am J Physiol 1991;260:E101–10.
Southren AL, Gordon GG, Tochimoto S, et al. Mean plasma concentration, metabolic clearance and basal plasma production rates of testosterone in normal young men and women using a constant infusion procedure: effect of time of day and plasma concentration on the metabolic clearance rate of testosterone. J Clin Endocrinol Metab 1967;27:686–94.
Frasier SO, Lippe BM. Clinical review 11: the rational use of growth hormone during childhood. J Clin Endocrinol Metab 1990;71:269–73.
Aceto T, Frazier SD, Hayles AB, et al. Collaborative study of the effects of human growth hormone in growth hormone deficiency; I. First year of therapy. J Clin Endocrinol Metab 1972;35:483–96.
Wilson JD, Griffin JE. The use and misuse of androgens. Metabolism 1980;29:1278–95.
Cuneo RC, Salomon F, Wiles CM, et al. Growth hormone treatment in growth hormone-deficient adults; I. Effects on muscle mass and strength. J Appl Physiol 1991;70:688–94.
Cuneo RC, Salomon F, Wiles CM, et al. Growth hormone treatment in growth hormone-deficient adults; II. Effects on exercise performance. J Appl Physiol 1991;70:695–700.
Degerblad M, Elgindy N, Hall K, et al. Potent effect of recombinant growth hormone on bone mineral density and body composition in adults with panhypopituitarism. Acta Endocrinol (Copenh) 1992;126:387–93.
Christiansen JS, Jorgensen JO, Pedersen SA, et al. Effects of growth hormone on body composition in adults. Horm Res 1991;36:73–81.
Rudman D, Feller AG, Nagraj HS, et al. Effect of human growth hormone in men over sixty years old. N Engl J Med 1990;323:1–6.
Snyder PJ. Clinical use of androgens. Annu Rev Med 1984;35:207–17.
Tenover JS. Effects of testosterone supplementation in the aging male. J Clin Endocrinol Metab 1992;75:1092–8.
Crist DM, Peake GT, Egan PA, et al. Body composition response to exogenous GH during training in highly conditioned adults. J Appl Physiol 1988;65:579–84.
Crist DM, Stackpole PJ, Peake GT. Effects of androgenic-anabolic steroids on neuromuscular power and body composition. J Appl Physiol 1983;54: 366–70.
Herndon DN, Barrow RE, Kunkel KR, et al. Effects of recombinant human growth hormone on donor-site healing in severely burned children. Ann Surg 1990;212:424–30.
Koskinen EVS, Lindholm RV, Nieminen RA, et al. Human growth hormone in delayed union and non-union of fractures. Int Orthop 1978;1: 317–22.
Ward HC, Halliday D, Sim JW. Protein and energy metabolism with biosynthetic human growth hormone after gastrointestinal surgery. Ann Surg 1987;206:56–61.
Hall K, Sara VR. Somatomedin levels in childhood, adolescence and adult life. Clin Endocrinol Metab 1984;13:91–112.
Clemmons DR, Van Wyk JJ. Factors controlling blood concentration of somatomedin C. Clin Endocrinol Metab 1984;13:113–43.
Furlanetto RW, Underwood LE, Van Wyk JJ, et al. Estimation of somatomedin C levels in normals and patients with pituitary disease by radioimmunoassay. J Clin Invest 1977;60:648–57.
Daughaday WH, Mariz IK, Blethen SL. Inhibition of access of bound somatomedin to membrane receptor and immunobinding sites: a comparison of radioreceptor and radioimmunoassay of somatomedin in native and acidethanol-extracted serum. J Clin Endocrinol Metab 1980;51:781–8.
Zadik Z, Chalew SA, McCarter RJ Jr, et al. The influence of age on the 24-hour integrated concentration of growth hormone in normal individuals. J Clin Endocrinol Metab 1985;60:513–6.
Ho KY, Evans WS, Blizzard RM, et al. Effects of sex and age on the 24-hour profile of growth hormone secretion in men: importance of endogenous estradiol concentrations. J Clin Endocrinol Metab 1987;64:51–8.
Jorgensen JOL, Moller N, Lauritzen T, et al. Evening versus morning injections of growth hormone (GH) in GH-deficient patients: effects on 24-hour patterns of circulating hormones and metabolites. J Clin Endocrinol Metab 1990;70:207–14.
Rudman D, Friedes D, Patterson JH, et al. Diurnal variation in the responsiveness of human subjects to human growth hormone. J Clin Invest 1973;52:912–8.
Jorgensen JO. Human growth hormone replacement therapy: pharmacological and clinical aspects. Endocr Rev 1991;12:189–207.
Findlay JC, Place V, Snyder PJ. Treatment of primary hypogonadism in men by the transdermal administration of testosterone. J Clin Endocrinol Metab 1989;68:369–73.
Snyder PJ, Lawrence DA. Treatment of male hypogonadism with testosterone enanthate. J Clin Endocrinal Metab 1980;51:1335–9.
Cohn L, Feller AG, Draper MW, et al. Carpal tunnel syndrome and gynecomastia during growth hormone treatment in elderly men with low circulating IGF-I concentrations. Clin Endocrinol 1993;139:417–25.
Kaiser FE, Silver AJ, Morley JE. The effect of recombinant human growth hormone on malnourished older individuals. J Am Geriatr Soc 1991;39:235–40.
Pape GS, Friedman M, Underwood LE, et al. The effect of growth hormone on weight gain and pulmonary function in patients with chronic obstructive lung disease. Chest 1991;99:1495–500.
Binnerts A, Wilson JH, Lamberts SW. The effects of human growth hormone administration in elderly adults with recent weight loss. J Clin Endocrinol Metab 1988;67:1312–6.
Clemmons DR, Snyder DK, Williams R, et al. Growth hormone administration conserves lean body mass during dietary restriction in obese subjects. J Clin Endocrinol Metab 1987;64:878–82.
Jiang ZM, He GZ, Zhang SY, et al. Low dose growth hormone and hypocaloric nutrition attenuate the protein-catabolic response after major operation. Ann Surg 1989;210:513–25.
Manson JM, Wilmore DW. Positive nitrogen balance with human growth hormone and hypocaloric intravenous feeding. Surgery 1986;100:188–97.
Herndon DN, Barrow RE, Kunkel KR, et al. Effects of recombinant human growth hormone on donor-site healing in severely burned children. Ann Surg 1990;212:424–31.
Horber FF, Haymond MW. Human growth hormone prevents the protein catabolic side effects of prednisone in humans. J Clin Invest 1990;86:265–72.
Morley JE, Perry NM 3rd, Kaiser FE, et al. Effects of testosterone replacement therapy in old hypogonadal males: a preliminary study. J Am Geriatr Soc 1993;41:149–52.
Jackson JA, Waxman J, Spiekerman AM. Prostatic complications of testosterone replacement therapy. Arch Intern Med 1989;149:2365–6.
Kraus DJ, Taub HA, Lantiga LJ, et al. Risks of blood volume changes in hypogonadal men treated with testosterone enenthate for erectile impotence. J Urol 1991;146:1566–70.
Uzych L. Anabolic-androgenic steroids and psychiatric related effects: a review. Can J Psychiatry 1992;37:23–8.
Mooradian AD, Morley JE, Korenman SG. Biological actions of androgens. Endocr Rev 1987;8:1–28.
Matsumoto AM, Sandblom RE, Schoene RB, et al. Testosterone replacement in hypogonadal men: effects on obstructive sleep apnoea, respiratory drives, and sleep. Clin Endocrinol 1985;22:713–21.
Daughaday WH. The possible autocrine/paracrine and endocrine roles of insulin-like growth factors of human tumors. Endocrinology 1990;127:1–4.
Macauly VM, Teale JD, Everard MJ, et al. Somatomedin-C/insulin-like growth factor-I is a mitogen for human small cell lung cancer. Br J Cancer 1988;57:91–3.
Cullen KJ, Yee D, Sly WS, et al. Insulin-like growth factor receptor expression and function in human breast cancer. Cancer Res 1990;50:48–53.
Jammes H, Peyrat JP, Ban E, et al. Insulin-like growth factor 1 receptors in human breast tumor: localisation and quantification by histo-autoradiographic analysis. Br J Cancer 1992;66:248–53.
Osborne CK, Clemmons DR, Arteaga CL. Regulation of breast cancer growth by insulin-like growth factors. J Steroid Biochem 1990;37:805–9.
Ezzat S, Melmed S. Clinical review 18: are patients with acromegaly at increased risk for neoplasia? J Clin Endocrinol Metab 1991;72:245–9.
Brunner JE, Johnson CC, Zafar S, et al. Colon cancer and polyps in acromegaly: increased risk associated with family history of colon cancer. Clin Endocrinol 1990;32:65–71.
Bengtsson BA, Eden S, Ernest I, et al. Epidemiology and long-term survival in acromegaly: a study of 166 cases diagnosed between 1955 and 1984. Acta Med Scand 1988;223:327–35.
Henderson BE, Ross RK, Pike MC, et al. Endogenous hormones as a major factor in human cancer. Cancer Res 1982;42:3232–9.
Bluestone R, Bywaters EG, Hartog M, et al. Acromegalic arthropathy. Ann Rheum Dis 1971;30:243–58.
Detenbeck LC, Tressler HA, O’Duffy JD, et al. Peripheral joint manifestations of acromegaly. Clin Orthop 1973;91:119–27.
Jadresic A, Banks LM, Child DF, et al. The acromegaly syndrome: relation between clinical features, growth hormone values and radiological characteristics of the pituitary tumours. Q J Med 1982;51:189–204.
Nabarro JDN. Acromegaly. Clin Endocrinol (Oxf) 1987;26:481–512.
Van der Werff ten Bosch JJ, Bot A. Growth hormone and androgen effects in the third decade. Acta Endocrinol Suppl 1986;279:29–34.
Zachmann M, Prader A. Anabolic and androgenic effect of testosterone in sexually immature boys and its dependency on growth hormone. J Clin Endocrinol Metab 1970;30:85–95.
Pertzelan A, Blum I, Grunebaum M, et al. The combined effect of growth hormone and methandrostenolone on the linear growth of patients with multiple pituitary hormone deficiencies,. Clin Endocrinol 1977;6:271–6.
MacGillivray MH, Kolotkin M, Munschauer RW. Enhanced linear growth responses in hypopituitary dwarfs treated with growth hormone plus androgen versus growth hormone alone. Pediatr Res 1974;8:103–8.
Ullea-Qguirre A, Blizzard RM, Garcia-Rubi E, et al. Testosterone and oxandrolone, a nonaromatizable androgen, specifically amplify the mass and rate of growth hormone (GH) secreted per burst without altering GH secretory burst duration or frequency or the GH half-life. J Clin Endocrinol Metab 1990;71:846–54.
Belgorosky A, Martinez A, Domene H, et al. High serum sex hormone-binding globulin (SHBG) and low serum non-SHBG-bound testosterone in boys with idiopathic hypopituitarism: effect of recombinant human growth hormone treatment. J Clin Endocrinol Metab 1987;65:107.
Corpas E, Harman SM, Pineyro MA, et al. Continuous subcutaneous infusions of growth hormone (GH) releasing hormone 1–44 for 14 days increase GH and insulin-like growth factor-I levels in old men. J Clin Endocrinol Metab 1993;76:134–8.
Corpas E, Harman SM, Pineyro MA, et al. Growth hormone (GH)-releasing hormone-(1–29) twice daily reverses the decreased GH and insulin-like growth factor-I levels in old men. J Clin Endocrinol Metab 1992;75: 530–5.
Chawla RK, Parks JS, Rudman D. Structural variants of human growth hormone: biochemical, genetic, and clinical aspects. Annu Rev Med 1983; 34:519–47.
Muller EE. Clinical implications of growth hormone feedback mechanisms. Horm Res 1990;33(suppl):90–6.
Clemmons DR. Editorial: role of insulin-like growth factor-I in reversing catabolism. J Clin Endocrinol Metab 1992;75:1183–5.
Leroith D, Clemmons D, Nissley P, et al. Insulin-like growth factors in health and disease. Ann Intern Med 1992;116:854–62.
DeVol DL, Rotwein P, Sadow JL, et al. Activation of insulin-like growth factor gene expression during work induced skeletal muscle growth. Am J Physiol 1990;259:E89–95.
Behringer RR, Lewin TM, Quaife CJ, et al. Expression of insulin-like growth factor-I stimulates normal somatic growth in growth hormone-deficient transgenic mice. Endocrinology 1990;127:1033–40.
Clemmons DR. Role of insulin-like growth factor-1 in reversing catabolism. J Clin Endocrinol Metab 1992;75:1183–5.
Laron Z, Anin S, Klipper-Aurbach YK, et al. Effects of insulin-like growth factor on linear growth, head circumference, and body fat in patients with Laron-type dwarfism. Lancet 1992;339:1258–61.
Clemmons DR, Smith-Banks A, Underwood LE. Reversal of diet-induced catabolism by infusion of recombinant insulin-like growth factor-I in humans. J Clin Endocrinol Metab 1992;75:234–8.
Guler HP, Zapf J, Scheiwiller E, et al. Recombinant human insulin-like growth factor-I stimulates growth and has distinct effects on organ size in hypophysectomized rats. Proc Natl Acad Sci USA 1988;85:4889–93.
Guler HP, Zapf J, Froesch ER. Short-term metabolic effects of recombinant human insulin-like growth factor-I in healthy adults. N Engl J Med 1987;317: 137–40.
Jacob R, Barrett E, Plewe G, et al. Acute effects of insulin-like growth factor I on glucose and amino acid metabolism in the awake fasted rat: comparison with insulin. J Clin Invest 1989;83:1717–23.
Guler HP, Schmid C, Zapf J, et al. Effects of recombinant insulin-like growth factor-I on insulin secretion and renal function in normal human subjects. Proc Natl Acad Sci USA 1989;86:2868–72.
Boulware SD, Tamborlane WV, Sherwin RS, et al. Diverse effects of insulin-like growth factor-I on glucose, lipid and amino acid metabolism. Am J Physiol 1992;262:E130–3.
Bennett AE, Wahner HW, Riggs BL, et al. Insulin-like growth factors I and II: aging and bone density in women. J Clin Endocrinol Metab 1984;59:7014.
Gray A, Feldman HA, McKinlay JB, et al. Age, disease and changing sex hormone levels in middle aged men: results of the Massachusetts male aging study. J Clin Endocrinol Metab 1991;73:1016–25.
Yamaji T, Ibayashi H. Plasma dehydroepiandrosterone sulfate in normal and pathological conditions. J Clin Endocrinol Metab 1969;29:273–8.
Smith MR, Rudd BT, Shirley A, et al. A radioimmunoassay for the estimation of serum dehydroepiandrosterone sulphate in normal and pathological sera. Clin Chim Acta 1975;65:5–13.
Orentreich N, Brind JL, Rizer RL, et al. Age changes and sex differences in serum dehyroepiandrosterone sulfate concentrations throughout adulthood. J Clin Endocrinol Metab 1984;59:551–5.
Nordin BE, Robertson A, Seamark RF, et al. The relation between calcium absorption, serum dehydroepiandrosterone, and vertebral mineral density in postmenopausal women. J Clin Endocrinol Metab 1985;60:651–7.
Deutsch S, Benjamin F, Seltzer V, et al. The correlation of serum estrogens and androgens with bone density in the late postmenopause. Int J Gynaecol Obstet 1987;25:217–22.
Devogelaer JP, Crabbe J, Nagant de Deuxchaisnes C. Bone mineral density in Addison’s disease: evidence for an effect of adrenal androgens on bone mass. Br Med J 1987;294:798–800.
Wild RA, Buchanan JR, Myers C, et al. Declining adrenal androgens: an association with bone loss in aging women. Proc Soc Exp Biol Med 1987; 186:355–60.
Taelman P, Kaufman JM, Janssens X, et al. Persistence of increased bone resorption and possible role of dehydroepiandrosterone as a bone metabolism determinant in osteoporotic women in late post menopause. Maturitas 1989;11:65–73.
Yen TT, Allan JA, Pearson DV, et al. Prevention of obesity in Avy/a mice by dehydroepiandrosterone. Lipids 1977;12:409–13.
Cleary MP, Shepherd A, Jenks B. Effect of dehydroepiandrosterone on growth in lean and obese Zucker rats. J Nutr 1984;114:1242–51.
Nestler JE, Barlascini CO, Clore NJ, et al. Dehydroepiandrosterone reduces serum low density lipoprotein levels and body fat but does not alter insulin sensitivity in normal men. J Clin Endocrinol Metab 1988;66:57–61.
Ettinger B, Genant HK, Cann CE. Long term estrogen replacement therapy prevents bone loss and fracture. Ann Intern Med 1985;102:319–24.
Ettinger B, Genant HK, Cann CE. Post menopausal bone loss is prevented by treatment with low-dosage estrogen with calcium. Ann Intern Med 1987; 106:40–5.
Aloia JF, Vaswani A, Kapoor A, et al. Treatment of osteoporosis with calcitonin, with and without growth hormone. Metab Clin Exp 1985;34: 124–9.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1995 Springer Science+Business Media New York
About this paper
Cite this paper
Rudman, D., Shetty, K.R. (1995). Potential Benefits and Risks in Treating the Hyposomatomedinemia and Hypogonadism of Elderly Men. In: Blackman, M.R., Roth, J., Harman, S.M., Shapiro, J.R. (eds) GHRH, GH, and IGF-I. Serono Symposia USA. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-0807-5_23
Download citation
DOI: https://doi.org/10.1007/978-1-4612-0807-5_23
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4612-6908-3
Online ISBN: 978-1-4612-0807-5
eBook Packages: Springer Book Archive