BES2003 Poster Presentations Neuroendocrinology and Behaviour (16 abstracts)
A randomised double-blind cross-over study of GH treatment in patients over 60 years
PM Mah 1 , SJ Walters 1 , JD Newell-Price 1 , J Webster 1 , A Doane 1 , V Ibbotson 1 , JP Hosker 2 , TH Jones 3 , KK Ho 4 , R Eastell 1 & RJ Ross 1
1Sheffield University, Sheffield, UK; 2Doncaster Royal Infirmary, Doncaster, UK; 3Barnsley General Hospital, Barnsley, UK; 4The Garvan Institute of Medical Research, Sydney, Australia.
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.
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Endocrine Abstracts
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