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Article: A randomized controlled trial of low-dose recombinant human growth hormone in the treatment of malnourished elderly medical patients

TitleA randomized controlled trial of low-dose recombinant human growth hormone in the treatment of malnourished elderly medical patients
Authors
Issue Date2001
PublisherThe Endocrine Society. The Journal's web site is located at http://jcem.endojournals.org
Citation
Journal Of Clinical Endocrinology And Metabolism, 2001, v. 86 n. 5, p. 1913-1920 How to Cite?
AbstractHigh-dose recombinant human GH (rhGH) has been shown to improve the nutritional status of malnourished older adults. It is uncertain whether low-dose rhGH is effective and whether its effect on nutritional status will lead to any improvement in physical function. There is also no data on the outcome after a short course of rhGH treatment. The objectives of this study were to determine the efficacy of low-dose rhGH treatment for 4 weeks in malnourished elderly patients, its effect on physical functions, and the intermediate term outcome after a 4-week rhGH treatment. The study design was a randomized, placebo-controlled, double-blind trial conducted in a university teaching hospital. The patients were 19 medically stable malnourished elderly subjects. Intervention in the rhGH group was as follows: rhGH (Saizen, Serono, Switzerland) 0.09 IU/kg body weight (BW) 3 times weekly were given together with appropriate dietary intervention as prescribed by the dietitian. In the placebo group, equal volumes of normal saline per kilogram BW were given 3 times weekly together with the dietary intervention. The baseline demographic, anthropometric, nutritional, and hematological variables, measures of physical function, and insulin-like growth factor I levels in both groups were comparable. Compared with the placebo group, the GH-treated group showed a more rapid gain in BW (after 3 weeks, +1.27 ± 0.36 vs. -0.28 ± 0.37 kg; P = 0.008), total lean body mass (change after 3 weeks by bio-impedance analysis, +1.45 ± 0.36 vs. -0.37 ± 0.48 kg; P = 0.009) and a faster improvement in 5-m walking time (decrease after 4 weeks, 23.79 ± 9.41 vs. 0.45 ± 4.62 sec; P = 0.047). The hemoglobin level rose more in the rhGH than the placebo groups (change at 8 weeks, +0.84 ± 0.34 vs. -0.42 ± 0.29 g/dL; P = 0.012). Serum albumin level also showed a greater delayed increase in the rhGH group than in the placebo group (change at 8 weeks, +5.1 ± 0.8 vs. 1.6 ± 1.2 g/dL; P = 0.023). There was no statistically significant difference for other nutritional variables. There was a greater rise in the mean serum insulin-like growth factor I level at 4 weeks in the GH than in the placebo groups (197 ± 58 vs. 54 ± 26 U/L; P = 0.034). The improvement in the rhGH group gradually diminished on follow-up and became statistically insignificant 8 weeks after stopping rhGH treatment. There were no GH-related adverse effects. Low-dose rhGH was an effective and safe adjuvant to dietary augmentation for stable malnourished elderly subjects. It led to a faster gain in total lean body mass, which was associated with greater improvement in walking speed when compared with dietary intervention alone. There were no apparent side effects.
Persistent Identifierhttp://hdl.handle.net/10722/162491
ISSN
2015 Impact Factor: 5.531
2015 SCImago Journal Rankings: 2.940
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChu, LWen_US
dc.contributor.authorLam, KSLen_US
dc.contributor.authorTam, SCFen_US
dc.contributor.authorHu, WJHCen_US
dc.contributor.authorHui, SLen_US
dc.contributor.authorChiu, Aen_US
dc.contributor.authorChiu, KCen_US
dc.contributor.authorNg, Pen_US
dc.date.accessioned2012-09-05T05:20:30Z-
dc.date.available2012-09-05T05:20:30Z-
dc.date.issued2001en_US
dc.identifier.citationJournal Of Clinical Endocrinology And Metabolism, 2001, v. 86 n. 5, p. 1913-1920en_US
dc.identifier.issn0021-972Xen_US
dc.identifier.urihttp://hdl.handle.net/10722/162491-
dc.description.abstractHigh-dose recombinant human GH (rhGH) has been shown to improve the nutritional status of malnourished older adults. It is uncertain whether low-dose rhGH is effective and whether its effect on nutritional status will lead to any improvement in physical function. There is also no data on the outcome after a short course of rhGH treatment. The objectives of this study were to determine the efficacy of low-dose rhGH treatment for 4 weeks in malnourished elderly patients, its effect on physical functions, and the intermediate term outcome after a 4-week rhGH treatment. The study design was a randomized, placebo-controlled, double-blind trial conducted in a university teaching hospital. The patients were 19 medically stable malnourished elderly subjects. Intervention in the rhGH group was as follows: rhGH (Saizen, Serono, Switzerland) 0.09 IU/kg body weight (BW) 3 times weekly were given together with appropriate dietary intervention as prescribed by the dietitian. In the placebo group, equal volumes of normal saline per kilogram BW were given 3 times weekly together with the dietary intervention. The baseline demographic, anthropometric, nutritional, and hematological variables, measures of physical function, and insulin-like growth factor I levels in both groups were comparable. Compared with the placebo group, the GH-treated group showed a more rapid gain in BW (after 3 weeks, +1.27 ± 0.36 vs. -0.28 ± 0.37 kg; P = 0.008), total lean body mass (change after 3 weeks by bio-impedance analysis, +1.45 ± 0.36 vs. -0.37 ± 0.48 kg; P = 0.009) and a faster improvement in 5-m walking time (decrease after 4 weeks, 23.79 ± 9.41 vs. 0.45 ± 4.62 sec; P = 0.047). The hemoglobin level rose more in the rhGH than the placebo groups (change at 8 weeks, +0.84 ± 0.34 vs. -0.42 ± 0.29 g/dL; P = 0.012). Serum albumin level also showed a greater delayed increase in the rhGH group than in the placebo group (change at 8 weeks, +5.1 ± 0.8 vs. 1.6 ± 1.2 g/dL; P = 0.023). There was no statistically significant difference for other nutritional variables. There was a greater rise in the mean serum insulin-like growth factor I level at 4 weeks in the GH than in the placebo groups (197 ± 58 vs. 54 ± 26 U/L; P = 0.034). The improvement in the rhGH group gradually diminished on follow-up and became statistically insignificant 8 weeks after stopping rhGH treatment. There were no GH-related adverse effects. Low-dose rhGH was an effective and safe adjuvant to dietary augmentation for stable malnourished elderly subjects. It led to a faster gain in total lean body mass, which was associated with greater improvement in walking speed when compared with dietary intervention alone. There were no apparent side effects.en_US
dc.languageengen_US
dc.publisherThe Endocrine Society. The Journal's web site is located at http://jcem.endojournals.orgen_US
dc.relation.ispartofJournal of Clinical Endocrinology and Metabolismen_US
dc.rightsJournal of Clinical Endocrinology and Metabolism. Copyright © The Endocrine Society.-
dc.subject.meshAgeden_US
dc.subject.meshBody Composition - Drug Effectsen_US
dc.subject.meshBody Weight - Drug Effectsen_US
dc.subject.meshDouble-Blind Methoden_US
dc.subject.meshEnergy Intakeen_US
dc.subject.meshFemaleen_US
dc.subject.meshGrowth Hormone - Adverse Effects - Therapeutic Useen_US
dc.subject.meshHumansen_US
dc.subject.meshInsulin-Like Growth Factor I - Analysisen_US
dc.subject.meshMaleen_US
dc.subject.meshNutrition Disorders - Drug Therapyen_US
dc.titleA randomized controlled trial of low-dose recombinant human growth hormone in the treatment of malnourished elderly medical patientsen_US
dc.typeArticleen_US
dc.identifier.emailLam, KSL:ksllam@hku.hken_US
dc.identifier.authorityLam, KSL=rp00343en_US
dc.description.naturelink_to_OA_fulltexten_US
dc.identifier.doi10.1210/jc.86.5.1913en_US
dc.identifier.pmid11344184-
dc.identifier.scopuseid_2-s2.0-0034999369en_US
dc.identifier.hkuros57764-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0034999369&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume86en_US
dc.identifier.issue5en_US
dc.identifier.spage1913en_US
dc.identifier.epage1920en_US
dc.identifier.isiWOS:000168731600015-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridChu, LW=7202236665en_US
dc.identifier.scopusauthoridLam, KSL=8082870600en_US
dc.identifier.scopusauthoridTam, SCF=7202037323en_US
dc.identifier.scopusauthoridHu, WJHC=18835588600en_US
dc.identifier.scopusauthoridHui, SL=7202831766en_US
dc.identifier.scopusauthoridChiu, A=24568495800en_US
dc.identifier.scopusauthoridChiu, KC=7202988065en_US
dc.identifier.scopusauthoridNg, P=36658516600en_US

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