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MH. Liu, D. M. Bravata, I. Olkin, S. Nayak, B. Roberts, A. M. Garber and A.
R. Hoffman
Annals of Intern Med 2007; 104-115.
The purpose of
this review was to evaluate the safety and efficacy of growth hormone therapy in
the healthy elderly. HGH is widely used as an anti-aging therapy, and its use
for this purpose is believed to have increased more than ten-fold since the mid
1990s. This review and meta-analysis evaluated the effects of growth hormone on
body composition, exercise capacity, bone density, serum lipid levels and
glucose metabolism as well as identifying evidence of adverse effects.
MEDLINE and EMBASE databases were searched for English-language studies
published through November 2005. From the 3,028 articles reviewed, 18 study
samples were selected. The selected studies were randomized, controlled trials,
with a minimum of 10 participants. The review compared: GH treatment with no GH
treatment, GH treatment plus lifestyle interventions with lifestyle
interventions alone, studies where treatment duration was less than 26 weeks
with studies that were longer than 26 weeks and studies that evaluated only men
with those that evaluated only women.
The studies included 508
participants, 447 who completed the study, 220 of which received growth hormone,
representing 107 person-years of treatment. The study sizes were small,
averaging 28 participants, and the dropout rates in some studies were high. The
average age of participants was 68, and two thirds of all participants were
male,.
The GH interventions varied considerably in terms dosages and
length of treatment (2 to 52 weeks). Six of the studies that incorporated
lifestyle interventions, included an exercise regime, 1 study included a low
calorie, low fat diet.
Most studies provided outcome data on body
composition but few reported exercise capacity, bone density, serum lipid levels
and glucose metabolism outcomes. Lean body mass increased and fat mass decreased
in growth hormone treated groups compared with groups who did not receive growth
hormone. There were no significant differences between those who received GH
with a lifestyle intervention and those who did not. In the single study that
looked specifically at GH therapy and exercise, those participants received GH
had a significant increase in lean body mass compared with those receiving
exercise therapy only.
Adverse effects were significantly higher in
those participants treated with GH, with 27% requiring a decrease in dosage. The
most common effects were soft tissue edema, joint pain, carpal tunnel syndrome
and gynecomastia. Those studies evaluating glucose metabolism related adverse
effects reported slightly higher incidence in the GH treated patients.
The reviewers concluded that claims that GH as an anti-aging remedy is safe and
clinically beneficial in the healthy elderly, are not supported by the available
research data. There is, however, considerable evidence that suggests that GH
use in healthy older adults is associated with high rates of adverse events. The
risks far outweigh the benefits. Based on the evidence, GH cannot be recommended
as an anti-aging therapy.
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