Systematic review: the safety and efficacy of growth hormone in the healthy elderly.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 17227934 · doi:10.7326/0003-4819-146-2-200701160-00005
What was done
Authors searched MEDLINE and EMBASE through November 2005 for randomized controlled trials evaluating growth hormone (GH) therapy versus no GH, or GH plus lifestyle interventions versus lifestyle interventions alone. Eligible trials enrolled community-dwelling adults aged 50 years or older with a BMI of 35 kg/m2 or less without specific illness, treating participants for at least 2 weeks. Two authors independently abstracted data.
What was found
Across 31 articles representing 18 unique study populations, 220 participants receiving GH (107 person-years; mean age 69 years, mean BMI 28 kg/m2, mean duration 27 weeks) completed trials. Compared to controls, GH decreased fat mass by -2.1 kg (95% CI, -2.8 to -1.35) and increased lean body mass by 2.1 kg (95% CI, 1.3 to 2.9) (P < 0.001), with no significant change in weight (0.1 kg, 95% CI, -0.7 to 0.8; P = 0.87). Total cholesterol decreased by -0.29 mmol/L (-11.21 mg/dL; P = 0.006), losing significance after adjustment for body composition. Bone density and other lipid levels did not change. GH-treated participants experienced significantly more soft tissue edema, arthralgias, carpal tunnel syndrome, gynecomastia, and higher incidence of diabetes and impaired fasting glucose.
Why it matters
This systematic review demonstrates that growth hormone produces only small changes in body composition in healthy older adults while substantially increasing adverse events, providing no support for its use as an antiaging therapy.
Limits
Total sample size was small (220 completed GH recipients) and treatment durations were brief (mean 27 weeks). Important clinical outcomes were measured infrequently or heterogeneously across studies, preventing pooled synthesis.
Cited by
- supports Excess growth hormone can cause effusions into joint spaces leading to morning hand numbness.