Growth Hormone Deficiency in Elderly Patients with Hypothalamo-Pituitary Tumors

被引：9

作者：

Colao A. ^{[1
]}

Cerbone G. ^{[1
]}

Pivonello R. ^{[1
]}

Klain M. ^{[1
]}

Aimaretti G. ^{[1
]}

Faggiano A. ^{[1
]}

Di Somma C. ^{[1
]}

Salvatore M. ^{[1
]}

Lombardi G. ^{[1
]}

机构：

[1] Dept. Molec. Clin. Endocrinol. O., Federico II University, Via Sergio Pansini, 5, 80131, Naples

来源：

Pituitary | 1998年 / 1卷 / 1期

关键词：

GH; GH deficiency; IGF-I binding proteins; Pituitary diseases;

D O I：

10.1023/A:1009923025853

中图分类号：

学科分类号：

摘要：

In 18 patients with hypothalamo-pituitary diseases aged over 60 years and in 18 sex, age- and BMI-matched healthy subjects, the results of plasma IGF-I and IGF-BP3 levels and the GH response to GHRH+arginine test (GHRH+ATT) were correlated to the results of body composition, serum osteocalcin (OC) and urinary cross-linked N-telopeptides of type I collagen (Ntx) and the bone mineral density (BMD). In 10 patients and 10 controls, the GH response to ITT was also evaluated. The GH response to GHRH+ATT and ITT was markedly reduced in patients compared to controls (3.1 ± 0.7 vs. 23.2 ± 2.3 μg/L, P < 0.001 and 1.1 ± 0.3 vs. 6.4 ± 0.8 μg/L, P < 0.001), so all patients were classified as GHD, though no significant difference was found in plasma IGF-I and IGF-BP3 levels between the two groups. Body composition analysis revealed a significant increase of fat mass (37.4 ± 2.2 vs. 28.0 ± 1.0%, P < 0.001), a significant decrease of lean mass (62.6 ± 2.2 vs. 72.0 ± 1.0%, P < 0.001) and total body water (45.7 ± 1.5 vs. 52.5 ± 1.1%, P < 0.001) in patients compared to controls. Serum OC levels were lower (1.9 ± 0.1 vs. 4.6 ± 0.4 μg/L, P < 0.001) in patients than in controls, whereas urinary Ntx levels were similar. BMD values in lumbar spine (0.81 ± 0.02 vs. 0.90 ± 0.02 g/cm2, P < 0.01) and femoral neck (0.70 ± 0.02 vs. 0.82 ± 0.02 g/cm2, P < 0.001) were significantly lower in patients than in controls. A significant inverse correlation was found between GHD duration and lumbar spine (r = -0.73, P&1t; 0.001) or femoral neck (r = -0.81, P&1t; 0.001) BMD values and a significant direct correlation was found between GH peak after GHRH+ATT and lumbar BMD (r = 0.69, p = 0.001) in GHD patients. In conclusion, GHD in patients over 60 yrs aged with a characteristic history of hypothalamus-pituitary pathology is distinct from the physiological decline in GH secretion associated with aging.

引用

页码：59 / 67

页数：8

共 26 条

[1]

De Boer, H., Blok, G.-J., Van Der Veen, E.A., Clinical aspects of growth hormone deficiency in adults (1995) Endocr Rev, 16, pp. 63-86

[2]

Finklestein, J.W., Roffwarg, H.P., Boyar, R.M., Kream, J., Helman, L., Age-related change in the twenty-four-hour spontaneous secretion of growth hormone (1972) J Clin Endocrinol Metab, 35, pp. 665-670

[3]

Shibasaki, T., Shizume, K., Nakahara, M., Age related changes in plasma growth hormone response to growth hormone releasing factor in man (1984) J Clin Endocrinol Metab, 58, pp. 212-214

[4]

Iranmanesh, A., Lizarralde, G., Veldhuis, J.D., Age and relative obesity are specific negative determinants of the frequency and amplitude of growth hormone (GH) secretory bursts and the half-life of endogenous GH in healthy men (1991) J Clin Endocrinol Metab, 73, pp. 1081-1088

[5]

Corpas, E., Harman, S.M., Blackman, M.R., Human growth hormone and human aging (1993) Endocr Rev, 14, pp. 20-39

[6]

Clemmons, D.R., Van Wyk, J.J., Factors controlling blood concentrations of somatomedin C (1984) J Clin Endocrinol Metab, 13, pp. 113-143

[7]

Rudman, D., Kutner, M.H., Rogers, C.M., Lubin, M.F., Fleming, G.A., Bain, R.P., Impaired growth hormone secretion in the adult population: Relation to age and adiposity (1981) J Clin Invest, 67, pp. 1361-1369

[8]

Marcus, R., Butterfield, G., Holloway, L., Effects of short term administration of recombinant human growth hormone to elderly people (1990) J Clin Endocrinol Metab, 70, pp. 519-527

[9]

Rudman, D., Feller, A.G., Nagraj, H.S., Effects of human growth hormone in men over 60 years (1990) N Engl J Med, 323, pp. 1-6

[10]

Holloway, L., Butterfield, G., Hintz, R., Geusundheit, N., Marcus, R., Effects of recombinant human growth hormone on metabolic indices, body composition and bone turnover in healthy elderly women (1994) J Clin Endocrinol Metab, 79, pp. 470-479

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