合并症老年患者的生长激素治疗:系统综述

IF 1.6 4区 医学 Q4 CELL BIOLOGY
Olivia Tausendfreund, Martin Bidlingmaier, Sebastian Martini, Katharina Müller, Michaela Rippl, Katharina Schilbach, Ralf Schmidmaier, Michael Drey
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引用次数: 0

摘要

目的对老年患者使用生长激素进行激素替代仍是一个备受争议的研究课题,在临床实践中也很少使用。这种不情愿可能源于对不良反应的担忧,以及将生长激素作为抗衰老药物使用的不严谨态度。然而,对某些急性和慢性疾病患者的有益作用可以证明高龄患者使用激素是合理的。本系统性综述分析了对患有不同合并症的老年患者进行 GH 干预的随机对照研究,以评估其有益和有害影响。设计 采用系统性检索策略,从 PubMed、MEDLINE 和 Cochrane 图书馆中查找相关研究。纳入标准:参与者年龄超过 65 岁,随机对照试验涉及人生长激素 (GH),且至少有一种额外的合并症与有缺陷的体液轴无关。结果八项符合条件的研究涵盖了各种合并症,包括骨质疏松症、虚弱、慢性心力衰竭、髋部骨折、肌萎缩性脊髓侧索硬化症和血液透析。研究结果各不相同,包括身体成分、体能、力量、骨质密度、心血管参数、生活质量和住房情况的变化。研究方案在使用 GH 的频率(每天、第 2 天或每周 3 次)、剂量(0.41 毫克-2.6 毫克;平均每 60 公斤患者 1.3 毫克)和持续时间(1-12 个月;平均 7 个月)方面存在很大差异。尽管证据有限,但 GH 治疗可带来多种益处,且不良反应较少。有必要进一步研究 IGF-I 依赖性适应症和明确的结果,并在老年人中采用 IGF-I 依赖性 GH 滴定法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Growth hormone treatment in aged patients with comorbidities: A systematic review

Objective

Hormonal substitution with growth hormone in aged patients remains a debated research topic and is rarely initiated in clinical practice. This reluctance may originate from concerns about adverse effects and the uncritical use as an anti-aging agent. Nevertheless, beneficial effects for selected patients suffering from certain acute and chronic illnesses could justify its use at an advanced age. This systematic review analyzes randomized controlled studies of GH interventions in older patients with different comorbidities to assess both, beneficial and harmful effects.

Design

A systematic search strategy was implemented to identify relevant studies from PubMed, MEDLINE, and The Cochrane Library. Inclusion criteria: participants aged over 65 years, randomized controlled trials involving human growth hormone (GH) and presence of at least one additional comorbidity independent of a flawed somatotropic axis.

Results

The eight eligible studies encompassed various comorbidities including osteoporosis, frailty, chronic heart failure, hip fracture, amyotrophic lateral sclerosis and hemodialysis. Outcomes varied, including changes in body composition, physical performance, strength, bone mineral density, cardiovascular parameters, quality of life and housing situation. Study protocols differed greatly in GH application frequency (daily, 2nd day or 3×/week), doses (0.41 mg-2.6 mg; mean 1.3 mg per 60 kg patient) and duration (1-12 months; mean 7 months). Mild dose-related side effects were reported, alongside noticeable positive impacts particularly on body composition, functionality, and quality of life.

Conclusion

Despite limited evidence, GH treatment might offer diverse benefits with few adverse effects. Further research with IGF-I dependent indication and clear outcomes, incorporating IGF-I dependent GH titration in older adults is warranted.

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来源期刊
Growth Hormone & Igf Research
Growth Hormone & Igf Research 医学-内分泌学与代谢
CiteScore
3.30
自引率
0.00%
发文量
38
审稿时长
57 days
期刊介绍: Growth Hormone & IGF Research is a forum for research on the regulation of growth and metabolism in humans, animals, tissues and cells. It publishes articles on all aspects of growth-promoting and growth-inhibiting hormones and factors, with particular emphasis on insulin-like growth factors (IGFs) and growth hormone. This reflects the increasing importance of growth hormone and IGFs in clinical medicine and in the treatment of diseases.
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