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Growth Hormone and Sex Steroid Effects on Serum Glucose, Insulin, and Lipid Concentrations in Healthy Older Women and Men
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Journal of Clinical Endocrinology & Metabolism July 2009
Thomas Munzer M.D., S. Mitchell Harman M.D., Ph.D., John D. Sorkin M.D., Ph.D., and Marc R. Blackman M.D.*
From the Endocrine (TM, SMH, MRB) and Metabolism (JDS) Sections, Laboratory of Clinical Investigation, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD; Geriatrische Klinik, St. Gallen, Switzerland (TM); Kronos Longevity Research Institute, Phoenix, Arizona (SMH); Department of Veterans Affairs Baltimore Veterans Affairs Medical Center Geriatrics Research, Education, and Clinical Center (JDS and MRB), and the University of Maryland School of Medicine Claude D. Pepper Older Americans Independence Center, Baltimore MD (JDS); and the Division of Endocrinology and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD (MRB); and Research Service, Washington DC Veterans Affairs Medical Center, Washington, DC (MRB)
ABSTRACT
Context: With aging, GH, IGF-I and sex-steroid concentrations and glucose tolerance decrease, and body fat and serum lipids increase.
Objective: Assess GH and/or sex steroid administration effects on serum glucose, insulin, insulin sensitivity and lipids in older individuals.
Design: Double masked, 2x2 factorial, placebo-controlled, double dummy design
Intervention: GH and/or sex steroid (transdermal estradiol plus oral medroxyprogresterone acetate in women=HRT, testosterone enanthate=T in men) administration for six months
Participants: Healthy, community dwelling women (n=57) and men (n=74), ages 65-88 y (mean 72 y).
Main Outcome Measures: Serum glucose, insulin and insulin sensitivity (QUICKI and ISI) before and during an OGTT, and lipid profiles.
Results: In women, GH did not alter OGTT 120 min or 2-hour area under the curve (AUC) glucose values, but increased 120 min insulin and AUC insulin. There were no significant effects of HRT or GH+HRT. ISI and QUICKI decreased after GH. In men, GH increased 120 min and AUC glucose and insulin AUC. GH+T increased 120 min glucose, and glucose and insulin AUCs. T alone did not affect glucose or insulin. ISI decreased after GH and GH+T, whereas QUCKI decreased after GH. GH in women and men, and GH+T in men decreased QUICKI by 4 weeks. In women, HRT decreased total cholesterol and LDL-cholesterol, and GH decreased LDL-cholesterol. In men, total cholesterol decreased after T and GH+T. LDL-cholesterol decreased after GH and GH+T. GH increased serum triglycerides.
Conclusions: GH administration to healthy older individuals for six months increased insulin resistance with moderately beneficial effects on lipids.
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