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Growth Hormone and Function in Elderly Persons
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IN RESPONSE:
Feller and colleagues point out that growth hormone replacement in growth hormone-deficient younger adults results in improved strength. On the basis of these data, they suggest that the effect of growth hormone on muscle strength remains unresolved. We question the extent to which these data from younger adults with pathologically low growth hormone levels can be generalized to healthy older men with physiologic declines in growth hormone levels. Our participants were elderly (mean age, 75.0 years) and had low baseline IGF-1 levels (122 ng/mL) but were not frail. Thus, we have no data with which to assess the efficacy of growth hormone replacement in the frail elderly. However, we believe that the likely side-effect profile in frail older persons is worrisome.
Feller and colleagues also question whether we used the optimum dose of recombinant growth hormone. The dose used in our study (0.03 mg/kg of body weight three times a week) was the same as the dose Feller and associates used in their original study of recombinant growth hormone replacement in older men [1]. We have no data with which to assess the effect of different doses of recombinant human growth hormone on muscle strength, but we found no correlation between baseline plasma IGF-1 levels and muscle strength [2] or between change in plasma IGF-1 levels after 6 months of replacement and change in muscle strength.
Maxine A. Papadakis, MD
Department of Veterans Affairs Medical Center; San Francisco, CA 94121
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
