The effect of growth hormone (GH) replacement on muscle strength in patients with GH-deficiency: a meta-analysis.

Hdl Handle:
http://hdl.handle.net/10147/207909
Title:
The effect of growth hormone (GH) replacement on muscle strength in patients with GH-deficiency: a meta-analysis.
Authors:
Widdowson, W Matthew; Gibney, James
Affiliation:
Department of Endocrinology and Diabetes, Adelaide and Meath Hospital, Tallaght, , Dublin, Ireland.
Citation:
Clin Endocrinol (Oxf). 2010 Jun;72(6):787-92. Epub 2009 Sep 21.
Journal:
Clinical endocrinology
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207909
DOI:
10.1111/j.1365-2265.2009.03716.x
PubMed ID:
19769614
Abstract:
CONTEXT/OBJECTIVES: GH replacement increases muscle mass and reduces body fat in growth hormone deficiency (GHD) adults. A recent meta-analysis has demonstrated that this improvement in body composition is associated with improved exercise performance. The current meta-analysis was carried out to determine whether high-quality evidence exists to support a beneficial effect of GH replacement on strength. DESIGN/METHODS: An extensive Medline search/literature review identified eight studies with utilizable, robust data, involving 231 patients in nine cohorts. Previously unpublished data were sought from authors and obtained in two cases. All studies included were randomized, double-blind, placebo-controlled, of parallel or cross-over design and of an average 6.7 months duration. Information was retrieved in uniform format, with data pertaining to patient numbers, study-design, GH-dose, mean age, IGF-I levels and muscle strength measurements (isometric or isokinetic quadriceps strength) recorded. Data were analysed using a fixed-effects model, utilizing continuous data measured on different scales. A summary effect measure (d(s)) was derived for individual strength variables, whereas an overall summary effect was derived from the sum of all studies incorporating different variables; 95% CIs were calculated from the weighted variances of individual study effects. RESULTS: Analysis revealed no significant improvement, neither when all studies were combined (d(s) = +0.01 +/- 0.26) nor when measured individually (isometric quadriceps strength, d(s) = +0.02 +/- 0.32 and isokinetic quadriceps strength, d(s) = 0.00 +/- 0.45). CONCLUSIONS: Evidence from short-term controlled studies fails to support a benefit on muscle strength of GH replacement in GHD patients, which is likely to occur over a longer time-course, as seen in open-label studies.
Language:
eng
MeSH:
Adult; Algorithms; Exercise/physiology; Female; Growth Disorders/*drug therapy/physiopathology; *Hormone Replacement Therapy; Human Growth Hormone/deficiency/*pharmacology/*therapeutic use; Humans; Hypopituitarism/drug therapy/physiopathology; Male; Middle Aged; Muscle Strength/*drug effects/physiology; United States
ISSN:
1365-2265 (Electronic); 0300-0664 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorWiddowson, W Matthewen_GB
dc.contributor.authorGibney, Jamesen_GB
dc.date.accessioned2012-02-01T10:49:48Z-
dc.date.available2012-02-01T10:49:48Z-
dc.date.issued2012-02-01T10:49:48Z-
dc.identifier.citationClin Endocrinol (Oxf). 2010 Jun;72(6):787-92. Epub 2009 Sep 21.en_GB
dc.identifier.issn1365-2265 (Electronic)en_GB
dc.identifier.issn0300-0664 (Linking)en_GB
dc.identifier.pmid19769614en_GB
dc.identifier.doi10.1111/j.1365-2265.2009.03716.xen_GB
dc.identifier.urihttp://hdl.handle.net/10147/207909-
dc.description.abstractCONTEXT/OBJECTIVES: GH replacement increases muscle mass and reduces body fat in growth hormone deficiency (GHD) adults. A recent meta-analysis has demonstrated that this improvement in body composition is associated with improved exercise performance. The current meta-analysis was carried out to determine whether high-quality evidence exists to support a beneficial effect of GH replacement on strength. DESIGN/METHODS: An extensive Medline search/literature review identified eight studies with utilizable, robust data, involving 231 patients in nine cohorts. Previously unpublished data were sought from authors and obtained in two cases. All studies included were randomized, double-blind, placebo-controlled, of parallel or cross-over design and of an average 6.7 months duration. Information was retrieved in uniform format, with data pertaining to patient numbers, study-design, GH-dose, mean age, IGF-I levels and muscle strength measurements (isometric or isokinetic quadriceps strength) recorded. Data were analysed using a fixed-effects model, utilizing continuous data measured on different scales. A summary effect measure (d(s)) was derived for individual strength variables, whereas an overall summary effect was derived from the sum of all studies incorporating different variables; 95% CIs were calculated from the weighted variances of individual study effects. RESULTS: Analysis revealed no significant improvement, neither when all studies were combined (d(s) = +0.01 +/- 0.26) nor when measured individually (isometric quadriceps strength, d(s) = +0.02 +/- 0.32 and isokinetic quadriceps strength, d(s) = 0.00 +/- 0.45). CONCLUSIONS: Evidence from short-term controlled studies fails to support a benefit on muscle strength of GH replacement in GHD patients, which is likely to occur over a longer time-course, as seen in open-label studies.en_GB
dc.language.isoengen_GB
dc.subject.meshAdulten_GB
dc.subject.meshAlgorithmsen_GB
dc.subject.meshExercise/physiologyen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshGrowth Disorders/*drug therapy/physiopathologyen_GB
dc.subject.mesh*Hormone Replacement Therapyen_GB
dc.subject.meshHuman Growth Hormone/deficiency/*pharmacology/*therapeutic useen_GB
dc.subject.meshHumansen_GB
dc.subject.meshHypopituitarism/drug therapy/physiopathologyen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshMuscle Strength/*drug effects/physiologyen_GB
dc.subject.meshUnited Statesen_GB
dc.titleThe effect of growth hormone (GH) replacement on muscle strength in patients with GH-deficiency: a meta-analysis.en_GB
dc.contributor.departmentDepartment of Endocrinology and Diabetes, Adelaide and Meath Hospital, Tallaght, , Dublin, Ireland.en_GB
dc.identifier.journalClinical endocrinologyen_GB
dc.description.provinceLeinster-

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