Growth hormone (GH) deficiency in adulthood, irrespective of aetiology, is associated with decreases in lean body mass (LBM) and muscle strength. Early studies indicated that GH replacement in adults with GH deficiency (GHD) normalized LBM and muscle strength, but these findings were complicated because the GH dose used in these early studies was calculated based on weight (as in children) and was subsequently found to be too high for adults, resulting in insulin-like growth factor I levels as high as those seen in individuals with acromegaly. More recent studies have, however, confirmed that GH replacement has a long-term beneficial effect on muscle mass and function in patients with GHD of all ages, although there appears to be a greater effect in normalizing muscle mass and function in young males and in adults with adult-onset GHD compared with those with childhood-onset GHD. Results also suggest that concomitant exercise training might further improve the outcome of GH replacement therapy.

Cuneo RC, Salomon F, Wiles CM, Hesp R, Sonksen PH: Growth hormone treatment in growth hormone deficient adults. I. Effects on muscle mass and strength. J Appl Physiol 1991;70:688–694.
Amato G, Carella C, Fazio S, La Montagna G, Cittadini A, Sabatini D, Marciano-Mone C, Sacca L, Bellastella A: Body composition, bone metabolism, and heart structure and function in growth hormone (GH)-deficient adults before and after GH replacement therapy at low doses. J Clin Endocrinol Metab 1993;77:1671–1676.
Bengtsson BA, Eden S, Lonn L, Kvist H, Stokland A, Lindstedt G, Bosaeus I, Tolli J, Sjostrom L, Isaksson OG: Treatment of adults with growth hormone (GH)-deficiency with recombinant human GH. J Clin Endocrinol Metab 1993;76:309–317.
Rosen T, Bosaeus I, Tolli J, Lindstedt G, Bengtsson BA: Increased body fat mass and decreased extracellular fluid volume in adults with growth hormone deficiency. Clin Endocrinol (Oxf) 1993;38:63–71.
Salomon F, Cuneo RC, Hesp R, Sonksen PH: The effects of treatment with recombinant growth hormone on body composition and metabolism in adults with growth hormone deficiency. N Engl J Med 1989;321:1797–1803.
Jorgensen JO, Pedersen SA, Thuesen L, Jorgensen J, Ingemann-Hansen T, Skakkebaek NE, Christiansen JS: Beneficial effects of growth hormone treatment in GH-deficient adults. Lancet 1989;I:1221–1225.
Lonn L, Kvist H, Grangard U, Bengtsson BA, Sjostrom L: CT-determined body composition changes with recombinant human growth hormone treatment to adults with growth hormone deficiency. Basic Life Sci 1993;60:229–231.
Wuster C, Abs R, Bengtsson BA, Bennmarker H, Feldt-Rasmussen U, Hernberg-Stahl E, Monson JP, Westberg B, Wilton P; KIMS Study Group and the KIMS International Board. Pharmacia & Upjohn International Metabolic Database: The influence of growth hormone deficiency, growth hormone replacement therapy, and other aspects of hypopituitarism on fracture rate and bone mineral density. J Bone Miner Res 2001;16:398–405.
Russell-Jones DL, Weissberger AJ, Bowes SB, Kelly JM, Thomason M, Umpleby AM, Jones RH, Sonksen PH: Protein metabolism in growth hormone deficiency, and effects of growth hormone replacement therapy. Acta Endocrinol (Copenh) 1993;128(suppl 2):44–47.
Doessing S, Kjaer M: Growth hormone and connective tissue in exercise. Scand J Med Sci Sports 2005;15:202–210.
Jenkins PJ: Growth hormone and exercise: physiology, use and abuse. Growth Horm IGF Res 2001;11(suppl A):S71–S77.
Rosén T: Supraphysiological doses of growth hormone: effects on muscles and collagen in healthy active young adults. Horm Res 2006;66(suppl 1):98–104.
Harman SM, Blackman MR: The effects of growth hormone and sex steroid on lean body mass, fat mass, muscle strength, cardiovascular endurance and adverse events in healthy elderly women and men. Horm Res 2003;60(suppl 1):121–124.
Mersebach H, Feldt-Rasmussen U: Growth hormone and body composition; in Jørgensen JOL, Christiansen JS (eds): Growth Hormone Deficiency in Adults. Frontiers in Hormone Research. Basel, Karger, 2005, vol 33, pp185–195.
Janssen YJH, Doornbos J, Roelfsema F: Changes in muscle volume, strength and bioenergetics during recombinant human growth hormone (GH) therapy in adults with GH deficiency. J Clin Endocrinol Metab 1999;84:279–284.
Hulthen L, Bengtsson BA, Sunnerhagen KS, Hallberg L, Grimby G, Johannsson G: GH is needed for the maturation of muscle mass and strength in adolescents. J Clin Endocrinol Metab 2001;86:4765–4770.
Carroll PV, Drake WM, Maher KT, Metcalfe K, Shaw NJ, Dunger DB, Cheetham TD, Camacho-Hübner C, Savage MO, Monson JP: Comparison of continuation or cessation of growth hormone (GH) therapy on body composition and metabolic status in adolescents with severe GH deficiency at completion of linear growth. J Clin Endocrinol Metab 2004;89:3890–3895.
Juul A, Vahl N, Jorgensen JO, Christiansen JS, Sneppen SB, Feldt-Rasmussen U, Skakkebaek NE: Consequences of stopping growth hormone (GH) therapy in young GH deficient patients with childhood onset disease. Growth Horm IGF Res 1998;8(suppl A):15–19.
Vahl N, Juul A, Jorgensen JO, Orskov H, Skakkebaek NE, Christiansen JS: Continuation of growth hormone (GH) replacement in GH-deficient patients during transition from childhood to adulthood: a two-year placebo-controlled study. J Clin Endocrinol Metab 2000;85:1874–1881.
Mauras N, Pescovitz OH, Allada V, Messig M, Wajnrajch MP, Lippe B, the Transition Study Group: Limited efficacy of growth hormone (GH) during transition of GH deficient patients from adolescence to adulthood: a phase III multicenter, double-blind randomised two-year trial. J Clin Endocrinol Metab 2005;90:3946–3955.
Ezzat S, Fear S, Gaillard R-C, Gayle C, Landy H, Marcowitz S, Mattioni T, Nussey S, Rees A, Svanberg E: Gender-specific responses of lean body composition and non-gender specific cardiac function improvement after GH replacement in GH deficient adults. J Clin Endocrinol Metab 2002;87:2725–2733.
Abrahamsen B, Nielsen TL, Hangaard J, Gregersen G, Vahl N, Korsholm L, Hansen TB, Andersen M, Hagen C: Dose-, IGF-I- and sex-dependent changes in lipid profile and body composition during GH replacement therapy in adult onset GH deficiency. Eur J Endocrinol 2004;150:671–679.
Svensson J, Sunnerhagen KS, Johansson G: Five years of growth hormone replacement therapy in adults: age- and gender-related changes in isometric and isokinetic muscle strength. J Clin Endocrinol Metab 2003;88:2061–2069.
Attanasio AF, Bates PC, Ho KKY, Webb SM, Ross RJ, Strasburger CJ, Bouillon R, Crowe B, Selander K, Valle D, Lamberts SW: Human growth hormone replacement in adult hypopituitary patients: long-term effects on body composition and lipid status – 3-year results from the HypoCCS database. J Clin Endocrinol Metab 2002;87:1600–1606.
Götherström G, Bengtsson BA, Sunnerhagen KS, Johansson G, Svensson J: The effects of five-year growth hormone replacement therapy on muscle strength in elderly hypopituitary patients. Clin Endocrinol (Oxf) 2005;62:105–113.
Bollerslev J, Hallén J, Fougner KJ, Jørgensen AP, Kristo C, Fagertun H, Gudmundsen O, Burman P, Schreiner T: Low-dose GH improves exercise capacity in adults with GH deficiency: effects of a 22-month placebo-controlled trial. Eur J Endocrinol 2005;153:379–387.
Feldt-Rasmussen U, Wilton P, Jonsson P; KIMS Study Group; KIMS International Board: Aspects of growth hormone deficiency and replacement in elderly hypopituitary adults. Growth Horm IGF Res 2004;14 (suppl A):51–58.
Monson JP, Abs R, Bengtsson BA, Bennmarker H, Feldt-Rasmussen U, Hernberg-Stahl E, Thoren M, Westberg B, Wilton P, Wuster C: Growth hormone deficiency and replacement in elderly hypopituitary adults. KIMS Study Group and the KIMS International Board. Pharmacia and Upjohn International Metabolic Database. Clin Endocrinol (Oxf) 2000;53:281–289.
Werlang CC, Rebello VC, Resende LOBR, Vaisman M, Gil Soares AC: Muscle power increases after resistance training in growth-hormone-deficient adults. Med Sci Sports Exerc 2002;34:1577–1581.
Feldt-Rasmussen U, Abs R, Bengtsson BA, Bennmarker H, Bramnert M, Hernberg-Stahl E, Monson JP, Westberg B, Wilton P, Wuster C; KIMS International Study Board on behalf of KIMS Study Group: Growth hormone deficiency and replacement in hypopituitary patients previously treated for acromegaly or Cushing’s disease. Eur J Endocrinol 2002;146: 67–74.
Johansson G, Sunnerhagen KS, Svensson J: Baseline characteristics and the effects of two years of growth hormone replacement therapy in adults with growth hormone deficiency previously treated for Cushing’s disease. Clin Endocrinol 2004;60:550–559.
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