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Homer KA, Cross MR, Helms ER. An examination of the associations between nutritional peaking strategies in physique sport and competitor characteristics. J Int Soc Sports Nutr 2024; 21:2377178. [PMID: 39007897 PMCID: PMC11251432 DOI: 10.1080/15502783.2024.2377178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 07/02/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND Physique athletes are subjectively judged on their on-stage esthetic per their competition division criteria. To succeed, competitors look to acutely enhance their appearance by manipulating nutritional variables in the days leading up to competition, commonly referred to as peak week (PW). Despite their documented wide adoption, PW strategies lack experimental evidence. Further, the relationship between the specific strategies and the characteristics of the competitors who implement them are unknown. The aim of this research was to examine the effect of competitor characteristics on the specific nutritional peaking strategies implemented, the length of these strategies, and the range of daily carbohydrate (CHO) intakes during these strategies. METHODS A 58-item survey was developed to gather information on peak week nutrition and training practices of physique athletes. A total of 160 respondents above the age of 18 who had competed in the last 5 years completed the nutrition section. The topics analyzed for this paper included competitor demographics, peaking strategies utilized, and PW CHO intakes. Competitor demographics are presented with the use of descriptive statistics. Associations between competitor demographics and peaking strategies implemented, peaking strategy length, and daily CHO intake ranges were assessed using multiple logistic regression, multiple ordinal logistic regression, and linear mixed models, respectively. RESULTS From the sampled population, ages 24-39 years (71.2%), male (68.8%), natural (65%), and amateur (90%) were the most common characteristics from their respective categories, while mean competition preparation length was 20.35 ± 8.03 weeks (Males: 19.77 ± 7.56 weeks, Females: 21.62 ± 8.93 weeks), competition preparation body mass loss was 11.5 ± 5.56 kg (M: 12.7 ± 5.76 kg, F: 7.16 ± 3.99 kg), and competition body mass was 72.09 ± 15.74 kg (M: 80.15 ± 11.33 kg, F: 54.34 ± 7.16 kg). For males, the highest and lowest daily CHO intake during PW were 489.63 ± 224.03 g (6.22 ± 2.93 g/kg body mass) and 148.64 ± 152.01 g (1.94 ± 2.17 g/kg), respectively, while for females these values were 266.73 ± 131.23 g (5.06 ± 2.67 g/kg) and 94.42 ± 80.72 g (1.81 ± 1.57 g/kg), respectively. CHO back loading (45%) and water loading (40.6%) were the most popular peaking strategies, while the most prevalent peaking strategy length was 7 days (27.2%). None of the competitor characteristics predicted the use of CHO-based peaking strategies nor peaking strategy length. For non-CHO-based strategies, drug-enhanced competitors were more likely to restrict water than non-drug enhanced, while males and professional competitors had greater odds of loading sodium than females and amateurs, respectively. Finally, when comparing the disparity in highest and lowest CHO intakes during peak week, sex was the only significant factor. CONCLUSIONS The results of this survey provide further information on the nutritional peaking strategies implemented by competitors. Certain characteristics were identified as predictors of sodium loading and water restriction, and the range of daily PW CHO intake. Contrastingly, no associations were found for CHO-based peaking strategies or peaking strategy length. While our analyses may be underpowered, and thus results should be interpreted with caution, it appears the nutritional peaking strategies implemented by physique competitors are seemingly complex and highly individual.
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Affiliation(s)
- Kai A. Homer
- Auckland University of Technology, Sport Performance Research Institute New Zealand (SPRINZ), Auckland, New Zealand
| | - Matt R. Cross
- Auckland University of Technology, Sport Performance Research Institute New Zealand (SPRINZ), Auckland, New Zealand
| | - Eric R. Helms
- Auckland University of Technology, Sport Performance Research Institute New Zealand (SPRINZ), Auckland, New Zealand
- Florida Atlantic University, Department of Exercise Science and Health Promotion, Muscle Physiology Laboratory, Boca Raton, FL, USA
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GPR101 drives growth hormone hypersecretion and gigantism in mice via constitutive activation of G s and G q/11. Nat Commun 2020; 11:4752. [PMID: 32958754 PMCID: PMC7506554 DOI: 10.1038/s41467-020-18500-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 08/25/2020] [Indexed: 12/16/2022] Open
Abstract
Growth hormone (GH) is a key modulator of growth and GH over-secretion can lead to gigantism. One form is X-linked acrogigantism (X-LAG), in which infants develop GH-secreting pituitary tumors over-expressing the orphan G-protein coupled receptor, GPR101. The role of GPR101 in GH secretion remains obscure. We studied GPR101 signaling pathways and their effects in HEK293 and rat pituitary GH3 cell lines, human tumors and in transgenic mice with elevated somatotrope Gpr101 expression driven by the rat Ghrhr promoter (GhrhrGpr101). Here, we report that Gpr101 causes elevated GH/prolactin secretion in transgenic GhrhrGpr101 mice but without hyperplasia/tumorigenesis. We show that GPR101 constitutively activates not only Gs, but also Gq/11 and G12/13, which leads to GH secretion but not proliferation. These signatures of GPR101 signaling, notably PKC activation, are also present in human pituitary tumors with high GPR101 expression. These results underline a role for GPR101 in the regulation of somatotrope axis function.
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He X, Barkan AL. Growth hormone therapy in adults with growth hormone deficiency: a critical assessment of the literature. Pituitary 2020; 23:294-306. [PMID: 32060708 DOI: 10.1007/s11102-020-01031-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Growth hormone (GH) therapy has been studied as treatment for clinical manifestations of adult-onset growth hormone deficiency (AO-GHD), including cardiovascular risk, bone health, and quality of life. Patients with AO-GHD typically also have significant history of pituitary pathology and hypopituitarism, which raises the question of what proportion of their clinical presentation can be attributed to GHD alone. Currently, much of the existing data for GH therapy in AO-GHD come from uncontrolled retrospective studies and observational protocols. These considerations require careful reassessment of the role of GH as a therapeutic agent in adult patients with hypopituitarism. METHODS We contrast results from placebo-controlled trials with those from uncontrolled and retrospective studies for GH replacement in patients with hypopituitarism. We also examine the evidence for the manifestations of AO-GHD being attributed to GHD alone, as well as the data on adults with congenital, life-long untreated isolated GHD. RESULTS The evidence for increased morbidity and mortality in hypopituitary patients with GHD, and for the benefits of GH therapy, are conflicting. There remains the possibility that the described clinical manifestations of AO-GHD may not be due to GHD alone, but may also be related to underlying pituitary pathology, treatment history and suboptimal hormone replacement. CONCLUSIONS In the setting of inconsistent data on the benefits of GH therapy, treatment of AO-GHD remains an individualized decision. There is a need for more randomized, placebo-controlled studies to evaluate the long-term outcomes of GH therapy in adults with hypopituitarism.
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Affiliation(s)
- Xin He
- Division of Metabolism, Endocrinology & Diabetes, Department of Internal Medicine, University of Michigan, Domino's Farms, Lobby G, Suite 1500, 24 Frank Lloyd Wright Drive, Ann Arbor, MI, 48106, USA
| | - Ariel L Barkan
- Division of Metabolism, Endocrinology & Diabetes, Department of Internal Medicine, University of Michigan, Domino's Farms, Lobby G, Suite 1500, 24 Frank Lloyd Wright Drive, Ann Arbor, MI, 48106, USA.
- Department of Neurosurgery, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA.
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Sergeeva KV, Miroshnikov AB, Smolensky AV. Effect of Growth Hormone Administration on the Mass and Strength of Muscles in Healthy Young Adults: A Systematic Review and Meta-Analysis. ACTA ACUST UNITED AC 2019. [DOI: 10.1134/s0362119719030162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Affiliation(s)
- Shlomo Melmed
- From the Pituitary Center, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles
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Sgrò P, Sansone M, Sansone A, Sabatini S, Borrione P, Romanelli F, Di Luigi L. Physical exercise, nutrition and hormones: three pillars to fight sarcopenia. Aging Male 2019; 22:75-88. [PMID: 29451419 DOI: 10.1080/13685538.2018.1439004] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Sarcopenia is a pathophysiological condition diffused in elderly people; it represents a social issue due to the longer life expectancy and the growing aging population. It affects negatively quality of life and it represents a risk factor for other pathologies, such as diabetes, cardiovascular disease, and obesity. No silver bullet exists to hinder sarcopenia, but it may be counteracted by physical exercise, nutrition, and a proper endocrine milieu. Indeed, we aim to analyze the scientific literature to give to clinician effective advices to counteract sarcopenia. Main text: Physical exercise, proper nutrition, optimized hormonal homeostasis represent the three pillars to fight sarcopenia. Physical exercise represents the most effective remedy to face sarcopenia, in particular if it is combined with a proper diet and with an adequate endocrine milieu. Consistency in training, adequate daily protein intake and eugonadism seems to be the keys to fight sarcopenia. The combination of these three pillars might act synergistically. CONCLUSIONS Optimization of these factors may increase their efficiency; however, scientific data may be sometimes confusing so far. Therefore, we aim to give practical advices to clinician to identify and to highlight the most important aspects in each of these three factors that should be addressed.
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Affiliation(s)
- Paolo Sgrò
- a Department of Movement, Human and Health Sciences, Unit of Endocrinology , Università degli Studi di Roma "Foro Italico" , Rome , Italy
| | - Massimiliano Sansone
- b Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology , Sapienza - Università di Roma , Rome , Italy
| | - Andrea Sansone
- b Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology , Sapienza - Università di Roma , Rome , Italy
| | - Stefania Sabatini
- c Department of Movement, Human and Health Sciences, Unit of Biology, Genetics and Biochemistry , Università degli Studi di Roma "Foro Italico" , Rome , Italy
| | - Paolo Borrione
- d Department of Movement, Human and Health Sciences, Unit of Internal Medicine , Università degli Studi di Roma "Foro Italico" , Rome , Italy
| | - Francesco Romanelli
- b Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology , Sapienza - Università di Roma , Rome , Italy
| | - Luigi Di Luigi
- a Department of Movement, Human and Health Sciences, Unit of Endocrinology , Università degli Studi di Roma "Foro Italico" , Rome , Italy
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Hermansen K, Bengtsen M, Kjær M, Vestergaard P, Jørgensen JOL. Impact of GH administration on athletic performance in healthy young adults: A systematic review and meta-analysis of placebo-controlled trials. Growth Horm IGF Res 2017; 34:38-44. [PMID: 28514721 DOI: 10.1016/j.ghir.2017.05.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 05/02/2017] [Accepted: 05/09/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Illicit use of growth hormone (GH) as a performance-enhancing drug among athletes is prevalent, although the evidence of such effects in healthy, young subjects is sparse. We therefore performed a meta-analysis of published studies on the effect of GH administration on body composition, substrate metabolism, and athletic performance in healthy, young subjects. DESIGN The English-language based databases PubMed, EMBASE, and Cochrane Central Register of Controlled Trials were searched, and eligible articles were reviewed in accordance with the PRISMA guidelines. Fifty-four potentially relevant articles were retrieved of which 11 were included in this analysis comprising 254 subjects. RESULTS Administration of GH significantly increased lean body mass (p<0.01) and decreased fat mass (p<0.01). In addition, GH increased the exercising levels of glycerol (p=0.01) and free fatty acids (p<0.01), but did not alter the respiratory quotient during exercise (p=0.30). GH significantly increased anaerobic exercise capacity (p<0.01) in the only study which investigated this, but did not over weeks to months improve muscle strength (p=0.36) or maximum oxygen uptake (p=0.89). CONCLUSION GH administration elicits significant changes in body composition, but does not increase either muscle strength or aerobic exercise capacity in healthy, young subjects.
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Affiliation(s)
- Kasper Hermansen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
| | - Mads Bengtsen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Michael Kjær
- Institute of Sports Medicine, Department of Orthopedic Surgery M, Bispebjerg Hospital and Centre for Healthy Aging, Faculty of Health and Medical Science, University of Copenhagen, Denmark
| | - Peter Vestergaard
- Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark; Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
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Fink J, Kikuchi N, Nakazato K. Effects of rest intervals and training loads on metabolic stress and muscle hypertrophy. Clin Physiol Funct Imaging 2016; 38:261-268. [DOI: 10.1111/cpf.12409] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 11/11/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Julius Fink
- Graduate Schools of Health and Sport Science; Nippon Sport Science University; Tokyo Japan
| | - Naoki Kikuchi
- Department of Training Science; Nippon Sport Science University; Tokyo Japan
| | - Koichi Nakazato
- Graduate Schools of Health and Sport Science; Nippon Sport Science University; Tokyo Japan
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Lopes AJ, Ferreira AS, Walchan EM, Soares MS, Bunn PS, Guimarães FS. Explanatory models of muscle performance in acromegaly patients evaluated by knee isokinetic dynamometry: Implications for rehabilitation. Hum Mov Sci 2016; 49:160-9. [DOI: 10.1016/j.humov.2016.07.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Revised: 07/05/2016] [Accepted: 07/06/2016] [Indexed: 12/21/2022]
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Abstract
BACKGROUND Communal online folk pharmacology fuels the drive for short cuts in attaining muscle enhancement, fat loss, and youthful skin. OBJECTIVES The study used "netnography" to explore female use of CJC-1295, a synthetic growth hormone analogue from the perspectives contained in Internet forum activity. METHODS A systematic Internet search was conducted using variation of the term "CJC-1295"; and combined with "forum." Ninety-six hits related to bodybuilding websites where CJC-1295 was mentioned. Following application of exclusion criteria to confine to female use and evidence of forum activity, 9 sites remained. These were searched internally for reference to CJC-1295. Twenty-three discussion threads relating to female use of CJC-1295 formed the end data set, and analyzed using the Empirical Phenomenological Psychological method. RESULTS Forum users appeared well versed and experienced in the poly use of performance and image drug supplementation. Choice to use CJC-1295 centered on weight loss, muscle enhancement, youthful skin, improved sleep, and injury healing. Concerns were described relating to female consequences of use given gender variations in growth hormone pulses affecting estimation of dosage, cycling, and long-term consequences. CONCLUSIONS Public health interventions should consider female self-medicating use of synthetic growth hormone within a repertoire of product supplementation, and related adverse health consequences.
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Affiliation(s)
- Marie Claire Van Hout
- a Waterford Institute of Technology , Health, Sport and Exercise Science , Waterford , Ireland
| | - Evelyn Hearne
- b Liverpool John Moore's University , Liverpool , United Kingdom
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11
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Birzniece V. Doping in sport: effects, harm and misconceptions. Intern Med J 2015; 45:239-48. [DOI: 10.1111/imj.12629] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 10/26/2014] [Indexed: 11/28/2022]
Affiliation(s)
- V. Birzniece
- School of Medicine; University of Western Sydney; Sydney New South Wales Australia
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12
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Winhofer Y, Wolf P, Krššák M, Wolfsberger S, Tura A, Pacini G, Gessl A, Raber W, Kukurova IJ, Kautzky-Willer A, Knosp E, Trattnig S, Krebs M, Luger A. No evidence of ectopic lipid accumulation in the pathophysiology of the acromegalic cardiomyopathy. J Clin Endocrinol Metab 2014; 99:4299-306. [PMID: 25148232 DOI: 10.1210/jc.2014-2242] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT PATIENTS with acromegaly frequently display disturbances of glucose and lipid metabolism, which might contribute to their increased cardiovascular risk. Because insulin resistance and increased lipolysis have been linked to ectopic lipid deposition, altered lipid accumulation in the liver and the myocardium might contribute to metabolic and cardiac complications in these patients. OBJECTIVE The aim of this study was to investigate myocardial (MYCL) and hepatic lipid content (HCL), insulin sensitivity, and cardiac function in active acromegaly and after control of GH excess through transsphenoidal surgery. PATIENTS Ten patients with newly diagnosed acromegaly (ACRO_active) were compared with 12 healthy controls (CON), matched for age, body mass index, and gender. In seven patients GH excess was controlled, and they were compared with their active state. METHODS MYCL and HCL were assessed by (1)H-magnetic resonance spectroscopy, pericardial fat and cardiac function by (1)H-magnetic resonance imaging, and insulin sensitivity and secretion by an oral glucose tolerance test. RESULTS Although MYCL tended to be lower, HCL was significantly lower in ACRO_active compared with CON (HCL: 1.2% ± 1.2% vs 4.3% ± 3.5% of (1)H-magnetic resonance spectroscopy signal, P < .02). Parameters of systolic function and hypertrophy were significantly increased in ACRO_active compared with CON, as were insulin secretion and resistance. After the control of GH excess, HCL and MYCL remained unchanged, but pericardial fat was increased in the patients in whom GH excess was controlled (from 11.6 ± 5.5 to 14.7 ± 6.2 cm(2), P = .02). CONCLUSION Acromegaly represents a unique condition characterized by low myocardial and hepatic lipid content despite decreased insulin sensitivity, hyperinsulinemia, and hyperglycemia. Hence, ectopic lipid accumulation does not appear to contribute to cardiac morbidity, and increased lipid oxidation might counteract ectopic lipid accumulation in GH excess.
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Affiliation(s)
- Yvonne Winhofer
- Department of Internal Medicine III, Division of Endocrinology and Metabolism (Y.W., P.W., M.Krš., A.G., W.R., A.K.-W., M.Kre., A.L.), Department of Biomedical Imaging and Image Guided therapy, Centre of Excellence High-field MR (M.Krš., I.J.K., S.T.), and Department of Neurosurgery (S.W., E.K.), Medical University of Vienna, A-1090 Vienna, Austria; and Institute of Biomedical Engineering (A.T., G.P.), National Research Council, Metabolic Unit, I-35127 Padova, Italy
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13
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Cox HD, Smeal SJ, Hughes CM, Cox JE, Eichner D. Detection andin vitrometabolism of AOD9604. Drug Test Anal 2014; 7:31-8. [DOI: 10.1002/dta.1715] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 08/06/2014] [Accepted: 08/07/2014] [Indexed: 11/09/2022]
Affiliation(s)
- Holly D. Cox
- Sports Medicine Research and Testing Laboratory; Salt Lake City UT 84108 USA
| | - Stacy J. Smeal
- Sports Medicine Research and Testing Laboratory; Salt Lake City UT 84108 USA
| | - Cole M. Hughes
- Sports Medicine Research and Testing Laboratory; Salt Lake City UT 84108 USA
| | - James E. Cox
- Department of Biochemistry and the Metabolmics Core Research Facility; University of Utah School of Medicine; Salt Lake City UT 84112 USA
| | - Daniel Eichner
- Sports Medicine Research and Testing Laboratory; Salt Lake City UT 84108 USA
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Kamenický P, Mazziotti G, Lombès M, Giustina A, Chanson P. Growth hormone, insulin-like growth factor-1, and the kidney: pathophysiological and clinical implications. Endocr Rev 2014; 35:234-81. [PMID: 24423979 DOI: 10.1210/er.2013-1071] [Citation(s) in RCA: 137] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Besides their growth-promoting properties, GH and IGF-1 regulate a broad spectrum of biological functions in several organs, including the kidney. This review focuses on the renal actions of GH and IGF-1, taking into account major advances in renal physiology and hormone biology made over the last 20 years, allowing us to move our understanding of GH/IGF-1 regulation of renal functions from a cellular to a molecular level. The main purpose of this review was to analyze how GH and IGF-1 regulate renal development, glomerular functions, and tubular handling of sodium, calcium, phosphate, and glucose. Whenever possible, the relative contributions, the nephronic topology, and the underlying molecular mechanisms of GH and IGF-1 actions were addressed. Beyond the physiological aspects of GH/IGF-1 action on the kidney, the review describes the impact of GH excess and deficiency on renal architecture and functions. It reports in particular new insights into the pathophysiological mechanism of body fluid retention and of changes in phospho-calcium metabolism in acromegaly as well as of the reciprocal changes in sodium, calcium, and phosphate homeostasis observed in GH deficiency. The second aim of this review was to analyze how the GH/IGF-1 axis contributes to major renal diseases such as diabetic nephropathy, renal failure, renal carcinoma, and polycystic renal disease. It summarizes the consequences of chronic renal failure and glucocorticoid therapy after renal transplantation on GH secretion and action and questions the interest of GH therapy in these conditions.
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Affiliation(s)
- Peter Kamenický
- Assistance Publique-Hôpitaux de Paris (P.K., M.L., P.C.), Hôpital de Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Le Kremlin Bicêtre F-94275, France; Univ Paris-Sud (P.K., M.L., P.C.), Faculté de Médecine Paris-Sud, Le Kremlin Bicêtre F-94276, France; Inserm Unité 693 (P.K., M.L., P.C.), Le Kremlin Bicêtre F-94276, France; and Department of Clinical and Experimental Sciences (A.G., G.M.), Chair of Endocrinology, University of Brescia, 25125 Brescia, Italy
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Guedes da Silva DP, Guimarães FS, Dias CM, Guimarães SDA, Kasuki L, Gadelha MR, Camilo GB, Lopes AJ. On the functional capacity and quality of life of patients with acromegaly: are they candidates for rehabilitation programs? J Phys Ther Sci 2013; 25:1497-501. [PMID: 24396219 PMCID: PMC3881486 DOI: 10.1589/jpts.25.1497] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 06/24/2013] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study compared patients having active acromegaly with those having
controlled acromegaly in terms of peripheral muscle strength, body composition, and
functional capacity. We also examined the associations between these measures. [Methods] A
total of 14 patients with active acromegaly, 12 patients with controlled acromegaly, and
12 healthy controls were subjected to isometric dynamometry, surface electromyography,
electrical bioimpedance, and a six-minute walk test. [Results] The active acromegaly group
exhibited significantly more fat-free mass than the control group. With respect to the
peripheral muscle performance, the controlled acromegaly group presented a significantly
lower electromyographic median frequency than the control group. The quadriceps maximum
strength was significantly lower in the controlled acromegaly group than in the control
group. The fat-free mass was significantly correlated with the quadriceps maximum
strength. The global scores of the Acromegaly Quality of Life Questionnaire were
significantly correlated with the six-minute walk distance. [Conclusion] Patients with
acromegaly have more fat-free mass, less peripheral muscle strength, and greater
fatigability than healthy control subjects. These findings depend on the degree of
hormonal control. In acromegalic patients, peripheral muscle strength is related to body
composition, and functional capacity is correlated with quality of life.
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Affiliation(s)
| | | | - Cristina Márcia Dias
- Rehabilitation Sciences Master's Program, Augusto Motta University Center, Brazil
| | | | - Leandro Kasuki
- Department of Endocrinology, Federal University of Rio de Janeiro, Brazil
| | | | | | - Agnaldo José Lopes
- Rehabilitation Sciences Master's Program, Augusto Motta University Center, Brazil
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Adams GR, Bamman MM. Characterization and regulation of mechanical loading-induced compensatory muscle hypertrophy. Compr Physiol 2013; 2:2829-70. [PMID: 23720267 DOI: 10.1002/cphy.c110066] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
In mammalian systems, skeletal muscle exists in a dynamic state that monitors and regulates the physiological investment in muscle size to meet the current level of functional demand. This review attempts to consolidate current knowledge concerning development of the compensatory hypertrophy that occurs in response to a sustained increase in the mechanical loading of skeletal muscle. Topics covered include: defining and measuring compensatory hypertrophy, experimental models, loading stimulus parameters, acute responses to increased loading, hyperplasia, myofiber-type adaptations, the involvement of satellite cells, mRNA translational control, mechanotransduction, and endocrinology. The authors conclude with their impressions of current knowledge gaps in the field that are ripe for future study.
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Affiliation(s)
- Gregory R Adams
- Department of Physiology and Biophysics, University of California Irvine, Irvine, California, USA.
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Boesen AP, Dideriksen K, Couppé C, Magnusson SP, Schjerling P, Boesen M, Kjaer M, Langberg H. Tendon and skeletal muscle matrix gene expression and functional responses to immobilisation and rehabilitation in young males: effect of growth hormone administration. J Physiol 2013; 591:6039-52. [PMID: 24081158 DOI: 10.1113/jphysiol.2013.261263] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
We examined the effect of growth hormone (GH) on connective tissue of tendon and skeletal muscle during immobilisation and re-training in humans. Young men (20-30 years; n = 20) were randomly assigned to daily recombinant human GH (rhGH) (33-50 μg kg(-1) day(-1)) or placebo (Plc), and had one leg immobilised for 2 weeks, followed by 6 weeks of strength training. The cross-sectional area (CSA), maximal muscle strength (maximal voluntary contraction, MVC) and biomechanical properties of the quadriceps muscle and patellar tendon were determined. Muscle and tendon biopsies were analysed for mRNA of collagen (COL1A1/3A1), insulin-like growth factors (IGF-1Ea/Ec), lysyl oxidase (LOX), matrix metalloproteases (MMP-2 and MMP-9), decorin and tenascin-C. Fibril morphology was analysed by transmission electron microscopy (TEM) to detect changes in the fibril diameter distribution. In muscle, CSA and MVC declined with immobilisation and recovered with rehabilitation similarly in both groups. Likewise, both groups showed increased IGF-1Ea/Ec and COL1A1/3A1 expression in muscle during re-training after immobilisation compared with baseline, and the increase was more pronounced when subjects received GH. The tendon CSA did not change during immobilisation, but increased in both groups during 6 weeks of rehabilitation (∼14%). A decline in tendon stiffness after immobilisation was observed only in the Plc group, and an increase during 6 weeks of rehabilitation was observed only in the GH group. IGF-1Ea and COL1A1/3A1 mRNA increased with immobilisation in the GH group only, and LOX mRNA was higher in the GH group than in the Plc group after immobilisation. Both groups showed an increase in MMP-2 with immobilisation, whereas no changes in MMP-9, decorin and tenascin-C were observed. The tendon fibril diameter distribution remained unchanged in both groups. In conclusion, GH stimulates collagen expression in both skeletal muscle and tendon, abolishes the normal inactivity-related decline in tendon stiffness and LOX, and results in increased tendon CSA and stiffness during rehabilitation. GH has a matrix-stabilising effect during periods of inactivity and rehabilitation in humans.
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Affiliation(s)
- A P Boesen
- A. P. Boesen: Institute of Sports Medicine, Department of Orthopaedic Surgery M, Bispebjerg Hospital, Bispebjerg Bakke 23, DK-2400 Copenhagen, Denmark.
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Simon D, Alberti C, Alison M, Le Henaff L, Chevenne D, Boizeau P, Canal A, Ollivier G, Decostre V, Jacqz-Aigrain E, Carel JC, Czernichow P, Hogrel JY. Effects of recombinant human growth hormone for 1 year on body composition and muscle strength in children on long-term steroid therapy: randomized controlled, delayed-start study. J Clin Endocrinol Metab 2013; 98:2746-54. [PMID: 23626006 DOI: 10.1210/jc.2012-4201] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Recombinant human GH (rhGH) improves growth and body composition in glucocorticoid-treated children. Its effects on muscle strength are poorly evaluated. OBJECTIVES Our objective was to evaluate rhGH effects on muscle strength in children receiving long-term glucocorticoid therapy; effects on height SD score (SDS) and body composition were assessed also. DESIGN AND SETTING A randomized, controlled, delayed-start study of rhGH for 12 months was started after randomization (baseline) or 6 months later (M6). PATIENTS Patients included 30 children with various diagnoses. INTERVENTION rhGH was administered at 0.065 mg/kg/d for 6 months and then in the dosage maintaining serum IGF-I levels below +2 SDS for chronological age. MAIN OUTCOME MEASURES The primary criterion was the between-group difference in composite index of muscle strength (CIMS) change at M6. Secondary criteria included between-group differences in CIMS SDS(height), lean mass (LM), thigh muscle area (MA), and height SDS changes at M6; these parameters were also assessed in the overall population after 1 year of rhGH therapy. RESULTS At M6, rhGH therapy did not significantly affect changes in CIMS or CIMS SDS(height) (+17.6% vs +7.5% and +0.14 ± 0.38 vs +0.11 ± 0.62, respectively); the rhGH-treated group had significantly larger changes in height SDS (+0.2 [0.3] vs -0.2 [0.3]; P = 0.003), LM (+7.3% [+3.7%; +21.6%] vs 0% [-4.7%; +3.2%]; P = 0.002), and MA (+8.8% [+5%; +15.6%] vs. -0.6% [-6.3%; +7.7%]; P = 0.01) compared with the untreated group. After 1 year of rhGH, height SDS, LM, and MA increased significantly, CIMS increased by 24.7% (+5.8%; +34.2%), and CIMS SDS(height) remained within the normal range. CONCLUSIONS rhGH increased height, LM, and MA. However, muscle strength did not improve significantly.
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Affiliation(s)
- Dominique Simon
- Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Service d'Endocrinologie Pédiatrique, 75019 Paris, France.
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19
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Madsen M, Krusenstjerna-Hafstrøm T, Møller L, Christensen B, Vendelbo MH, Pedersen SB, Frystyk J, Jessen N, Hansen TK, Stødkilde-Jørgensen H, Flyvbjerg A, Jørgensen JOL. Fat content in liver and skeletal muscle changes in a reciprocal manner in patients with acromegaly during combination therapy with a somatostatin analog and a GH receptor antagonist: a randomized clinical trial. J Clin Endocrinol Metab 2012; 97:1227-35. [PMID: 22298804 DOI: 10.1210/jc.2011-2681] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
CONTEXT Pegvisomant is a GH antagonist, which is used for the treatment of acromegalic patients. It effectively blocks the hepatic and peripheral effects of GH, but transient elevations in circulating liver enzymes of unknown pathogenesis may occur, which seems to be more prevalent when the treatment is combined with a somatostatin analog (SA). Accumulation of intrahepatic lipid is a known cause of elevated liver enzymes, and there is evidence to suggest that GH impacts lipid content in liver and skeletal muscle. OBJECTIVE Our objective was to measure lipid content in liver and skeletal muscle in acromegalic patients before and after cotreatment with pegvisomant and SA as compared with SA monotherapy. DESIGN Eighteen acromegalic patients well controlled on SA monotherapy were randomized in a parallel study over 24 wk to 1) unchanged SA monotherapy, or 2) cotreatment with pegvisomant (15-30 mg twice a week) and SA (half the usual dosage). SETTING This was an investigator-initiated study in a single tertiary referral center. MAIN OUTCOME MEASURES Intrahepatic lipid (IHL) and intramyocellular lipid (IMCL) was assessed by ¹H magnetic resonance spectroscopy. RESULTS IHL increased in the cotreatment group compared with SA only (P = 0.002). The increase was positively correlated to weekly pegvisomant dose (r² = 0.52; P = 0.01). By contrast, IMCL decreased in the cotreatment group compared with SA only (P = 0.01). These changes related neither to insulin sensitivity nor inflammatory markers. CONCLUSION Cotreatment with pegvisomant and a reduced SA dose increase IHL and decrease IMCL compared with SA monotherapy. The clinical implications remain unclear, but increased IHL may be causally linked to the transient elevations in liver enzymes observed during pegvisomant treatment.
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Affiliation(s)
- Michael Madsen
- Department of Internal Medicine and Endocriniology (MEA), Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus C, Denmark.
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20
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Hansen M, Skovgaard D, Reitelseder S, Holm L, Langbjerg H, Kjaer M. Effects of Estrogen Replacement and Lower Androgen Status on Skeletal Muscle Collagen and Myofibrillar Protein Synthesis in Postmenopausal Women. J Gerontol A Biol Sci Med Sci 2012; 67:1005-13. [DOI: 10.1093/gerona/gls007] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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21
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Birzniece V, Nelson AE, Ho KKY. Growth hormone and physical performance. Trends Endocrinol Metab 2011; 22:171-8. [PMID: 21420315 DOI: 10.1016/j.tem.2011.02.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Revised: 02/10/2011] [Accepted: 02/15/2011] [Indexed: 11/30/2022]
Abstract
There has been limited research and evidence that GH enhances physical performance in healthy adults or in trained athletes. Even so, human growth hormone (GH) is widely abused by athletes. In healthy adults, GH increases lean body mass, although it is possible that fluid retention contributes to this effect. The most recent data indicate that GH does not enhance muscle strength, power, or aerobic exercise capacity, but improves anaerobic exercise capacity. In fact, there are adverse effects of long-term GH excess such that sustained abuse of GH can lead to a state mimicking acromegaly, a condition with increased morbidity and mortality. This review will examine GH effects on body composition and physical performance in health and disease.
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Affiliation(s)
- Vita Birzniece
- Pituitary Research Unit, Garvan Institute of Medical Research and Department of Endocrinology, St Vincent's Hospital, Sydney, NSW 2010, Australia
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22
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Curtis VA, Allen DB. Boosting The Late Blooming Male: Use of growth promoting agents in the athlete with constitutional delay of growth and puberty. Sports Health 2010; 3:32-40. [PMID: 21691451 PMCID: PMC3117584 DOI: 10.1177/1941738110386705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Context: The indications for use of growth hormone have broadened with the availability of unlimited recombinant human growth hormone. The Food and Drug Administration’s approval for use of growth hormone in growth hormone–sufficient patients with idiopathic short stature includes some children with constitutional delay of growth and puberty. This is a normal growth pattern variation that includes delayed puberty and prolonged linear growth, usually leading to normal adult height. Use of recombinant human growth hormone to increase growth in short-statured children with constitutional growth delay has been challenged for its modest efficacy in increasing ultimate height, high cost, limited evidence for psychosocial benefit, and some unresolved concerns about long-term posttreatment safety. An additional controversy for the young athlete with constitutional growth delay is the concern for fairness in competition. Evidence Acquisition: A PubMed search of the literature from 1957 through May 2010 was conducted. Data sources were limited to peer-reviewed publications. Results: Recombinant human growth hormone is a safe and effective therapy for increasing growth rate in short children with constitutional growth delay, but it does not markedly increase ultimate stature nor confer a clear benefit in athletic performance. Conclusions: Prescribing physicians should use recombinant human growth hormone treatment responsibly to bring children disabled by short stature into just the normal range.
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Affiliation(s)
- Vanessa A Curtis
- Department of Pediatric Endocrinology and Diabetes, University of Wisconsin, Madison, Wisconsin, United States
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23
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Segura J. Is anti-doping analysis so far from clinical, legal or forensic targets?: The added value of close relationships between related disciplines. Drug Test Anal 2010; 1:479-84. [PMID: 20355162 DOI: 10.1002/dta.55] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
There are many areas of common interest between anti-doping laboratories and those working in the clinical, legal and forensic fields. In addition to methodological similarities, there are aspects of the findings in sport drug testing that overlap with other fields in such a way that sport drug testing and clinical, legal or forensic work may benefit from mutual interaction. Three recent examples are presented from the author's experience. Case report 1 concerns the clinical relevance of hCG findings in sport drug testing as potential indicators of the presence of a (testicular) tumour in athletes. Case report 2 refers to difficulties that accredited laboratories can encounter due to differences between national legal systems and the administrative regulation systems of sport authorities. The example involves a network of blood collection for further autologous transfusion. Case report 3 relates to additional forensic-type investigations needed to interpret a situation where intoxication of a whole delegation was responsible for apparent doping cases. Clinical, legal and forensic fields must recognize the added value that some results and developments coming from anti-doping laboratories may have. At the same time anti-doping analysts should be aware of new issues, methodologies and problems appearing in related fields.
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Affiliation(s)
- Jordi Segura
- Bioanalysis Research Group, IMIM-Hospital del Mar, Dr Aiguader 88, Barcelona, Spain.
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24
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Birzniece V, Nelson AE, Ho KKY. Growth hormone administration: is it safe and effective for athletic performance. Endocrinol Metab Clin North Am 2010; 39:11-23, vii. [PMID: 20122446 DOI: 10.1016/j.ecl.2009.10.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Human growth hormone (GH) is widely abused by athletes; however, there is little evidence that GH improves physical performance. Replacement of GH in GH deficiency improves some aspects of exercise capacity. There is evidence for a protein anabolic effect of GH in healthy adults and for increased lean body mass following GH, although fluid retention likely contributes to this increase. The evidence suggests that muscle strength, power, and aerobic exercise capacity are not enhanced by GH administration, however GH may improve anaerobic exercise capacity. There are risks of adverse effects of long-term abuse of GH. Sustained abuse of GH may lead to a state mimicking acromegaly, a condition with increased morbidity and mortality.
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Affiliation(s)
- Vita Birzniece
- Pituitary Research Unit, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
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25
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Doessing S, Heinemeier KM, Holm L, Mackey AL, Schjerling P, Rennie M, Smith K, Reitelseder S, Kappelgaard AM, Rasmussen MH, Flyvbjerg A, Kjaer M. Growth hormone stimulates the collagen synthesis in human tendon and skeletal muscle without affecting myofibrillar protein synthesis. J Physiol 2009; 588:341-51. [PMID: 19933753 DOI: 10.1113/jphysiol.2009.179325] [Citation(s) in RCA: 121] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
In skeletal muscle and tendon the extracellular matrix confers important tensile properties and is crucially important for tissue regeneration after injury. Musculoskeletal tissue adaptation is influenced by mechanical loading, which modulates the availability of growth factors, including growth hormone (GH) and insulin-like growth factor-I (IGF-I), which may be of key importance. To test the hypothesis that GH promotes matrix collagen synthesis in musculotendinous tissue, we investigated the effects of 14 day administration of 33-50 microg kg(-1) day(-1) recombinant human GH (rhGH) in healthy young individuals. rhGH administration caused an increase in serum GH, serum IGF-I, and IGF-I mRNA expression in tendon and muscle. Tendon collagen I mRNA expression and tendon collagen protein synthesis increased by 3.9-fold and 1.3-fold, respectively (P < 0.01 and P = 0.02), and muscle collagen I mRNA expression and muscle collagen protein synthesis increased by 2.3-fold and 5.8-fold, respectively (P < 0.01 and P = 0.06). Myofibrillar protein synthesis was unaffected by elevation of GH and IGF-I. Moderate exercise did not enhance the effects of GH manipulation. Thus, increased GH availability stimulates matrix collagen synthesis in skeletal muscle and tendon, but without any effect upon myofibrillar protein synthesis. The results suggest that GH is more important in strengthening the matrix tissue than for muscle cell hypertrophy in adult human musculotendinous tissue.
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Affiliation(s)
- Simon Doessing
- Institute of Sports Medicine, Bispebjerg Hospital, Center of Healthy Aging, Faculty of Health Sciences, University of Copenhagen, Copenhagen NV, Denmark.
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26
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Freda PU, Shen W, Reyes-Vidal CM, Geer EB, Arias-Mendoza F, Gallagher D, Heymsfield SB. Skeletal muscle mass in acromegaly assessed by magnetic resonance imaging and dual-photon x-ray absorptiometry. J Clin Endocrinol Metab 2009; 94:2880-6. [PMID: 19491226 PMCID: PMC2730874 DOI: 10.1210/jc.2009-0026] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
CONTEXT GH and IGF-I are nitrogen retaining and anabolic, but the impact of long-term exposure to supraphysiological GH and IGF-I, either from endogenous overproduction in acromegaly or exogenous sources, on skeletal muscle (SM) mass is not clear. OBJECTIVES The objectives of the study were to assess SM mass by whole-body magnetic resonance imaging (MRI) in acromegaly and test the hypothesis that dual-energy x-ray absorptiometry (DXA) lean tissue mass-derived estimates of SM accurately estimate true SM mass. DESIGN, SETTING, AND PATIENTS The design was a cross-sectional study in 27 acromegaly patients compared with predicted models developed in 315 nonacromegaly subjects and to matched controls. OUTCOME MEASURES Mass of SM from whole-body MRI and lean tissue from DXA were measured. RESULTS SM mass did not differ from predicted or control values in active acromegaly: 31.75 +/- 8.6 kg (acromegaly) vs. 33.06 +/- 8.9 kg (predicted); SM was 95.6 +/- 12.8% of predicted (range 66.7-122%) (P = 0.088). Lean tissue mass (DXA) was higher in acromegaly than controls: 65.91 +/- 15.2 vs. 58.73 +/- 13.5 kg (P < 0.0001). The difference between lean tissue mass (DXA) and SM in acromegaly patients was higher than that in controls (P < 0.0001) consistent with an enlarged non-SM lean compartment in acromegaly. SM mass predicted by DXA correlated highly with SM mass by MRI (r = 0.97, P < 0.0001). SM (MRI) to SM (DXA predicted) ratio was 1.018 (range 0.896-1.159), indicating high agreement of these measures of SM. CONCLUSIONS SM mass in active acromegaly patients did not differ from predicted values. SM mass estimated from DXA agreed highly with SM by MRI, supporting the validity of the DXA model in assessing SM in acromegaly and other disorders of GH/IGF-I secretion.
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Affiliation(s)
- Pamela U Freda
- Department of Medicine, Columbia University College of Physicians and Surgeons, 630 West 168th Street, New York, NY 10032, USA.
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27
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Graham MR, Baker JS, Evans P, Hullin D, Thomas NE, Davies B. Potential benefits of recombinant human growth hormone (rhGH) to athletes. Growth Horm IGF Res 2009; 19:300-307. [PMID: 19539505 DOI: 10.1016/j.ghir.2009.04.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/03/2009] [Indexed: 12/29/2022]
Abstract
Athletes have enjoyed almost a thirty year amnesty of rhGH abuse, which they consider has contributed to the winning of medals and the breaking of world records. Such a reprieve is almost at an end, since WADA have identified a method to detect rhGH abuse. Or have they? The anecdotal word "on the street" is that rhGH is still undetectable and athletes believe that the benefits, at the dosages they administer, far outweigh the risks! Scientists are aware that in a hormone deficiency condition, replacement can halt and in certain situations reverse some of the adverse effects. Growth hormone deficiency can lead to a loss of skeletal muscle mass and an increase in abdomino-visceral obesity, which is reversed on replacement with rhGH. Since the availability of GH, athletes have been trying to extrapolate these effects from the deficiency state to the healthy corpus and increase their sporting prowess. Past confessions from athletes, such as Ben Johnson, Kelly White, Tim Montgomery, Marion Jones and currently Dwain Chambers have demonstrated that they are prepared to tread the very fine lines that separate the "men from the boys". Rewards are so great, that anonymous surveys have identified that athletes will risk ill health, if they believe they can cheat, win and not get caught. The question that still needs to be answered is, "does growth hormone enhance performance"? Recent research suggests that it could. There is also a suspicion that in "cycled" low supraphysiological doses, it is no where near as harmful as WADA claim it to be.
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Affiliation(s)
- Michael R Graham
- The Newman Centre for Sport and Exercise Research, Newman University College, Birmingham, UK.
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28
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Ding J, List EO, Okada S, Kopchick JJ. Perspective: proteomic approach to detect biomarkers of human growth hormone. Growth Horm IGF Res 2009; 19:399-407. [PMID: 19501004 PMCID: PMC2760539 DOI: 10.1016/j.ghir.2009.04.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/03/2009] [Indexed: 10/20/2022]
Abstract
Several serum biomarkers for recombinant human growth hormone (rhGH) have been established, however, none alone or in combination have generate a specific, sensitive, and reproducible 'kit' for the detection of rhGH abuse. Thus, the search for additional GH specific biomarkers continues. In this review, we focus on the use of proteomics in general and two-dimensional electrophoresis (2-DE) in particular for the discovery of new GH induced serum biomarkers. Also, we review some of the protocols involved in 2-DE. Finally, the possibility of tissues other than blood for biomarker discovery is discussed.
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Affiliation(s)
- Juan Ding
- Edison Biotechnology Institute, College of Osteopathic Medicine, Ohio University, Athens, Ohio 45701, USA
- Molecular and Cellular Biology Program, College of Osteopathic Medicine, Ohio University, Athens, Ohio 45701, USA
- Department of Biological Sciences, College of Osteopathic Medicine, Ohio University, Athens, Ohio 45701, USA
| | - Edward O. List
- Edison Biotechnology Institute, College of Osteopathic Medicine, Ohio University, Athens, Ohio 45701, USA
| | - Shigeru Okada
- Edison Biotechnology Institute, College of Osteopathic Medicine, Ohio University, Athens, Ohio 45701, USA
- Department of Biomedical Sciences, College of Osteopathic Medicine, Ohio University, Athens, Ohio 45701, USA
| | - John J. Kopchick
- Edison Biotechnology Institute, College of Osteopathic Medicine, Ohio University, Athens, Ohio 45701, USA
- Molecular and Cellular Biology Program, College of Osteopathic Medicine, Ohio University, Athens, Ohio 45701, USA
- Department of Biomedical Sciences, College of Osteopathic Medicine, Ohio University, Athens, Ohio 45701, USA
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Graham MR, Evans P, Davies B, Baker JS. AAS, growth hormone, and insulin abuse: psychological and neuroendocrine effects. Ther Clin Risk Manag 2008; 4:587-97. [PMID: 18827854 PMCID: PMC2500251 DOI: 10.2147/tcrm.s2495] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The nontherapeutic use of prescription medicines by individuals involved in sport is increasing. Anabolic-androgenic steroids (AAS) are the most widely abused drug. Much of our knowledge of the psychological and physiological effects of human growth hormone (hGH) and insulin has been learned from deficiency states. As a consequence of the Internet revolution, previously unobtainable and expensive designer drugs, particularly recombinant human growth hormone (rhGH) and insulin, have become freely available at ridiculously discounted prices from countries such as China and are being abused. These drugs have various physiological and psychological effects and medical personnel must become aware that such prescription medicine abuse appears to be used not only for performance and cosmetic reasons, but as a consequence of psychological pre-morbidity.
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Affiliation(s)
- Michael R Graham
- Health and Exercise Science Research Unit, Faculty of Health Sport and Science, University of GlamorganPontypridd, Wales, United Kingdom
| | - Peter Evans
- Royal Gwent HospitalNewport, Gwent, United Kingdom
| | - Bruce Davies
- Health and Exercise Science Research Unit, Faculty of Health Sport and Science, University of GlamorganPontypridd, Wales, United Kingdom
| | - Julien S Baker
- Health and Exercise Science Research Unit, Faculty of Health Sport and Science, University of GlamorganPontypridd, Wales, United Kingdom
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Ehrnborg C, Rosén T. Physiological and pharmacological basis for the ergogenic effects of growth hormone in elite sports. Asian J Androl 2008; 10:373-83. [DOI: 10.1111/j.1745-7262.2008.00403.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Danilowicz K, Bruno OD, Manavela M, Gomez RM, Barkan A. Correction of cortisol overreplacement ameliorates morbidities in patients with hypopituitarism: a pilot study. Pituitary 2008; 11:279-85. [PMID: 18459045 DOI: 10.1007/s11102-008-0126-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
CONTEXT Hypopituitarism in adults is known to be associated with deleterious effects on body composition, lipid profile and quality of life (QoL). This was attributed to GH deficiency. The potential role of glucocorticoid overreplacement had never been investigated. OBJECTIVE To investigate whether reduction in glucocorticoid replacement dose to more physiological one could ameliorate the "AO-GHD"-attributed symptomatology in patients with hypopituitarism. Design Eleven patients with panhypopituitarism taking 20-30 mg/day of hydrocortisone, but on no GH replacement were switched to 10-15 mg of hydrocortisone daily. Both basally and 6-12 months later, their body mass index, body composition by dual-energy X-ray absorptiometry, lipid profile, and the score of quality of life, QOL-AGHDA were measured. RESULTS Within 6-12 months of lower hydrocortisone dose, subjects lost an average of 7.1 kg of total body fat and 4.1 kg of abdominal fat. No changes were seen in lean body mass, bone mineral content and HOMA-IR. Plasma total cholesterol and triglyceride concentrations decreased significantly (< 0.05) and the QoL improved (P = 0.018). CONCLUSIONS Our pilot study suggests that decreasing the glucocorticoid replacement dose to approximately 15 mg/day is beneficial in terms of patients' body composition, lipid profile and quality of life.
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Affiliation(s)
- Karina Danilowicz
- Division of Endocrinology, Hospital de Clínicas, Avenida Córdoba 2351, 5 degrees piso, 1120, Ciudad Autónoma de Buenos Aires, Argentina.
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32
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Technology Insight: detecting growth hormone abuse in athletes. ACTA ACUST UNITED AC 2007; 3:769-77. [DOI: 10.1038/ncpendmet0644] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2007] [Accepted: 07/26/2007] [Indexed: 11/09/2022]
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Badre-Esfahani S, Nellemann B, Danielsen D, Fisker S, Christiansen JS, Jørgensen JOL. Assessment of hydration by means of bioelectrical impedance and arm muscle area during growth hormone (GH) replacement therapy: A prospective study of 130 GH-deficient patients. Growth Horm IGF Res 2007; 17:227-233. [PMID: 17347010 DOI: 10.1016/j.ghir.2007.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2006] [Revised: 01/20/2007] [Accepted: 01/24/2007] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Growth hormone (GH)-deficiency is associated with a reduced extracellular volume (ECV), whereas GH replacement may cause fluid retention. We have tested a simple method to assess hydration in GH-deficient patients (GHD) based on concomitant measurements of body resistance by bioelectrical impedance analysis (BIA), and arm muscle area (AMA). DESIGN We prospectively followed 130 patients (54 females, 76 males) with adult-onset GHD before and during 1-5 years GH replacement therapy. METHODS Concomitant measurements of body resistance and AMA were done on four occasions: before treatment, after one month and one year of treatment, and at the most recent visit. Based on normative data obtained in 142 women and 84 men an inverse relationship was documented between body resistance and AMA. Assuming that linear height and the concentration of electrolytes remain constant, body resistance at a given AMA will reflect specific hydration. RESULTS In the patients a gender-specific inverse correlation between body resistance and AMA existed, which was different from the control group and changed during GH replacement. A deviation between predicted (based on normative data) and measured body resistance at a given AMA was recorded in the patients before and during therapy compatible with relative dehydration in the untreated state followed by an increase in hydration during therapy. CONCLUSIONS Concomitant measurements of BIA and AMA in GHD patients may provide a non-invasive and simple means to estimate hydration before and during GH replacement.
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Affiliation(s)
- Sara Badre-Esfahani
- Medical Department M (Endocrinology and Diabetes), Aarhus University Hospital, Nørrebrograde 44, DK-8000 C Aarhus, Denmark
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Ehrnborg C, Ohlsson C, Mohan S, Bengtsson BA, Rosén T. Increased serum concentration of IGFBP-4 and IGFBP-5 in healthy adults during one month's treatment with supraphysiological doses of growth hormone. Growth Horm IGF Res 2007; 17:234-241. [PMID: 17347011 DOI: 10.1016/j.ghir.2007.01.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2006] [Revised: 01/19/2007] [Accepted: 01/24/2007] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To study the effects on insulin-like growth factor binding proteins (IGFBP)-4 and -5 after one month's treatment with supraphysiological doses of growth hormone (GH) in healthy, active young adults with a normal GH-IGF-I axis. Furthermore, the possible use of IGFBP-4 and IGFBP-5 as markers of GH doping is discussed. DESIGN Thirty healthy, physically active volunteers (15 men and 15 women), mean age 25.9 years (range 18-35), participated in this randomized, double-blind, placebo-controlled, parallel study with three groups (n=10; 5 men and 5 women in each group). The groups comprised the following: placebo, GH 0.1IU/kg/day [0.033mg/kg/day] and GH 0.2IU/kg/day [0.067mg/kg/day]. RESULTS Baseline levels of IGFBP-4 were higher (+20%), while IGFBP-5 levels were lower (-37%) in women than in men. IGFBP-5 levels were positively correlated to age, but no significant correlation was found for IGFBP-4. In the pooled group with active GH treatment (n=20), both IGFBP-4 and IGFBP-5 levels were increased vs. the placebo group from day 14 until end of treatment [day 28, IGFBP-4 (+40%, p<0.01) and IGFBP-5 (+61%, p <0.001)]. After inclusion of serum IGF-I as a covariate in the linear regression analysis, the associations between GH treatment and the IGFBP-4 and IGFBP-5 levels were not significant. CONCLUSIONS This study shows that the levels of IGFBP-4 and IGFBP-5 are affected by supraphysiological GH treatment given to young, healthy, physically active adults of both genders. The present study, including relatively few subjects, does not support that IGFBP-4 and IGFBP-5 can be used as IGF-I independent markers in a forthcoming method for detecting GH doping, although, further studies are needed to investigate the potential use of IGFBP-4 and IGFBP-5 as markers of GH doping.
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Affiliation(s)
- Christer Ehrnborg
- Research Centre for Endocrinology and Metabolism (RCEM), Endocrine Division, Department of Internal Medicine, Gröna Stråket 8, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden.
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Apor P, Tihanyi J, Costa A. [Increase of muscle mass and strength with hormones and other drugs, combined with physical training]. Orv Hetil 2007; 148:451-6. [PMID: 17350911 DOI: 10.1556/oh.2007.27793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Increasing muscle mass and strength is the aim of some body builders and sportsmen, and is a therapeutic target in hormonal deficiencies, as well as in many clinical situations, when muscle devastation is a life-limiting factor. Human growth hormone, insulin-like growth factor, anabolic-androgen steroids and regulating proteins influencing muscle development and differentiation are used also for delaying the aging processes. Some of the practices are hailed by several myths, mainly because doping cases in certain competitive sports. Physiology, and therapeutic experiences with these substances are reviewed with special reference to physical exercise and to some frail conditions.
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Affiliation(s)
- Péter Apor
- Semmelweis Egyetem, Testnevelési és Sporttudományi Kar Humán Kineziológia Szak Budapest Czakó u. 9. 1016 Apor-Med Bt. Budapest, Hungary.
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