[Is it reasonable to prescribe growth hormones in the elderly?].
During normal aging, there is a +/- 60% decrease of the endogenous GH secretion ("somatopause"). However it is safe to prescribe GH therapy only to those people who show a clear cut decrease of GH release as evidenced by low integrated 24 hr secretion and/or low plasma IGF-1. In our view, a complete clinical check up must also show, on the one hand, an abnormal decrease of the optimal quality of life and, on the other hand a willing to maintain a reasonable intellectual and physical activity in the absence of major clinical and biological abnormalities. The benefits are likely to be an increase of muscular strength and of exercise tolerance, a decrease of trabecular osteopenia, a decrease of abdominal obesity, an increase of immunocompetence and a general improvement of the "quality of life". A "pharmacological" prescription is contra-indicated whereas very low dose regimen could induce, through feed back mechanism, a putative decrease of endogenous GH-RH (and GHRPs?) function whose deleterious psychoneuroendocrine effects remain to be demonstrated.
Service Universitaire d'Endocrinologie, Unité de Psychoneuroendocrinologie, CHU et CHR Citadelle.
J J
JJ
Legros
V
V
Geenen
P
P
Delmotte
D000203:Activities of Daily Living; D000368:Aged; D000375:Aging / Q000187:drug effects* / Q000502:physiology* / Q000523:psychology; D001851:Bone Diseases, Metabolic / Q000209:etiology / Q000517:prevention & control; D000075202:Contraindications; D011307:Drug Prescriptions; D017079:Exercise Tolerance; D015577:Geriatric Assessment; D019382:Human Growth Hormone / Q000172:deficiency* / Q000502:physiology / Q000627:therapeutic use*; D006801:Humans; D007108:Immune Tolerance / Q000187:drug effects / Q000502:physiology; D009765:Obesity / Q000209:etiology / Q000517:prevention & control; D018579:Patient Selection; D011788:Quality of Life; D012449:Safety
D019382:Human Growth Hormone