Five Years of Growth Hormone Replacement Therapy in Adults: Age- and Gender-Related Changes in Isometric and Isokinetic Muscle Strength
Johan Svensson,
Katharina Stibrant Sunnerhagen and
Gudmundur Johannsson
Research Centre for Endocrinology and Metabolism (J.S., G.J.) and Department of Rehabilitation Medicine (K.S.S.), Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden
Address all correspondence and requests for reprints to: Johan Svensson, M.D., Research Centre for Endocrinology and Metabolism, Gröna Stråket 8, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden. E-mail: johan.svensson{at}medic.gu.se.
GH replacement therapy in adults with adult-onset GH deficiency(GHD) has been shown to increase isometric and isokinetic musclestrength in a few trials with limited numbers of patients. Inthis single center, prospective, open-label study, the effectsof 5-yr GH replacement therapy on muscle function were determinedin 109 consecutive adults (61 men and 48 women) with adult-onsetGHD. The mean initial GH dose was 0.88 mg/d. The dose was graduallylowered, and after 5 yr the mean dose was 0.46 mg/d. The meanIGF-I SD score increased from -1.54 at baseline to 1.53 at studyend. A sustained increase in lean body mass and decrease inbody fat was observed. The GH treatment induced persistent increasesin isometric knee flexor strength, concentric knee flexor strengthat an angular velocity of 60 degrees/sec, and right-hand peakgrip strength. After correction for age and gender using observed/predictedvalue ratios, a sustained increase was also observed in isometric(60 degrees) and concentric (180 degrees/sec) knee extensorstrength, average right-hand grip strength for 10 sec, and left-handgrip strength. At study end, knee flexor and extensor strengthwas 96–104% of predicted and hand grip strength was 84–90%of predicted values. The local muscle endurance was transientlydecreased after correction for age and gender. No gender differencewas found in the treatment responses in muscle strength. However,muscle strength (also after correction for age and gender) waslower in women than men throughout the study period. In conclusion,GH replacement therapy in adults with adult-onset GHD normalizedisometric and isokinetic knee flexor and extensor strength.Hand grip strength increased but was not fully normalized.
This work was supported by the chair of Göteborg. Thesedata were presented in part at the 82nd Annual Meeting of TheEndocrine Society, Toronto, Canada, June 21–24, 2000.
Abbreviations: DEXA, Dual-energy x-ray absorptiometry; GHD,GH deficiency; LBM, lean body mass; TBK, total body potassium;TBN, total body nitrogen.
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