The Effect of Growth Hormone Replacement on Exercise Capacity in Patients with GH Deficiency: A Metaanalysis

Widdowson, W. Matthew; Gibney, James

doi:10.1210/jc.2008-1239

Cited by 97 publications

(56 citation statements)

References 29 publications

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“…In two recent meta-analyses including a few hundred adult GH-treated patients compared with untreated subjects, VO 2max increased by about 9% with rhGH treatment (11,42). However, this was observed in adults with AO GHD, and not in those with CO GHD.…”

Section: Discussionmentioning

confidence: 96%

“…Most of the studied subjects had multiple pituitary hormone deficiencies and were receiving appropriate replacement therapies. No similar study has been performed in children, although in adults with childhood-onset GHD solely, no significant improvement in exercise capacity was found upon GH replacement (11). These discrepancies could be due to the cause rather than the age of GHD onset: pituitary macroadenoma, the main cause of adult-onset GHD, is virtually nonexistent in children (12).…”

Section: Introductionmentioning

confidence: 99%

“…Placebo-controlled trials have shown an improvement in aerobic capacity in adults by GH replacement (11). Most of the studied subjects had multiple pituitary hormone deficiencies and were receiving appropriate replacement therapies.…”

Section: Introductionmentioning

confidence: 99%

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Impaired aerobic exercise adaptation in children and adolescents with craniopharyngioma is associated with hypothalamic involvement

Piguel¹,

Ábrahám²,

Bouhours‐Nouet³

et al. 2012

European Journal of Endocrinology

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Objective: Many patients treated for craniopharyngioma (CP) complain of a relative incapacity for physical activity. Whether this is due to an objective decrease in adaptation to exercise is unclear.We assessed exercise tolerance in children with surgically treated CP and appropriate pituitary hormone replacement therapy compared with healthy controls and we examined the potential relationships with hypothalamic involvement, GH replacement, and the catecholamine deficiency frequently observed in these subjects. Design and methods: Seventeen subjects (12 males and five females) with CP and 22 healthy controls (14 males and eight females) aged 15.3G2.5 years (7.3-18 years) underwent a standardized cycle ergometer test. Maximum aerobic capacity was expressed as the ratio of VO 2max to fat-free mass (VO 2max /FFM), a measure independent of age and fat mass in children. Results: VO 2max /FFM was 20% lower in children with CP compared with controls (P!0.05), even after adjustment for gender. Children with hypothalamic involvement (nZ10) had a higher percentage of fat mass (P!0.05) than those without hypothalamic involvement (nZ7) and lower VO 2max /FFM (P!0.05), whereas children without hypothalamic involvement had VO 2max /FFM close to that of controls (PO0.05). GH treatment was associated with a significant positive effect on aerobic capacity (P!0.05) only in the absence of hypothalamic involvement. No relationship was found between exercise capacity parameters and daily urine epinephrine excretion or epinephrine peak response to insulin-induced hypoglycemia. Conclusions: Children with CP have a decrease in aerobic capacity mainly related to hypothalamic involvement. The hypothalamic factors altering aerobic capacity remain to be determined.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

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Impaired aerobic exercise adaptation in children and adolescents with craniopharyngioma is associated with hypothalamic involvement

Piguel¹,

Ábrahám²,

Bouhours‐Nouet³

et al. 2012

European Journal of Endocrinology

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“…In patients with GH deficiency, evidence strongly favours GH replacement to improve body composition and mean muscle volume, 3 and to increase exercise and aerobic capacity. 5 GH deficiency is also associated with a higher rate of cardiovascular mortality, and replacement may return these rates to baseline in men. 6,7 To achieve the appropriate GH replacement, both clinical and IGF-1 responses are monitored and doses are titrated to achieve the desired therapeutic goals.…”

Section: Gh Excess and Supplementationmentioning

confidence: 99%

“…In spite of recognised improvements in strength following replacement in GH deficiency states, 5 it is contentious whether these benefits occur in the presence of a normal GH/IGF-1 axis.…”

Section: Gh and Skeletal Musclementioning

confidence: 99%

Effects of growth hormone therapy on exercise performance in men

Triay

Ahmad

2012

Trends Urol & Men's Health

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Hormone Replacement Therapy

Janssen

Lely

Rogol

et al. 2013

Pituitary Disorders

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vaccinationists, it is important to understand that they have deeply held beliefs, often of a spiritual or philosophical nature, 11 and these beliefs have remained remarkably constant over the better part of two centuries. The movement encompasses a wide range of individuals, from a few who express conspiracy theories, to educated, well informed consumers of health care, who often have a complex rationale for their beliefs, related to a "mixture of world views held about the environment, healing, holism. .. and a critical reading of the scientific and alternative literature." 12 Vaccination is unique among de facto mandatory requirements in the modern era, requiring individuals to accept the injection of a medicine or medicinal agent into their bodies, and it has provoked a spirited opposition. This opposition began with the first vaccinations, has not ceased, and probably never will. From this realisation arises a difficult issue: how should the mainstream medical authorities approach the anti-vaccination movement? A passive reaction could be construed as endangering the health of society, whereas a heavy handed approach can threaten the values of individual liberty and freedom of expression that we cherish. This creative tension will not leave us and cannot be cured by force alone.

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The Effect of Growth Hormone Replacement on Exercise Capacity in Patients with GH Deficiency: A Metaanalysis

Abstract: There is strong evidence that GH replacement improves exercise performance in GH-deficient patients. This evidence should be considered when decisions are made regarding prescription of GH.

Cited by 97 publications

References 29 publications

Impaired aerobic exercise adaptation in children and adolescents with craniopharyngioma is associated with hypothalamic involvement

Impaired aerobic exercise adaptation in children and adolescents with craniopharyngioma is associated with hypothalamic involvement

Effects of growth hormone therapy on exercise performance in men

Hormone Replacement Therapy

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