Testosterone, dehydroepiandrosterone, insulin-like growth factor 1, and insulin in sedentary and physically trained aged men.

The influence of physical activity on dehydroepiandrosterone sulfate (DHEAS), total and free testosterone (TT and FT, respectively), insulin-like growth factor I (IGF-1), follicle-stimulating hormone (FSH), luteinizing hormone (LH) and insulin concentrations in aging men was investigated. Eight trained and nine sedentary men aged 60-65 years volunteered to participate in this study. Physical activity was determined during an effort test and evaluated by the measure of the maximal aerobic power (W(aer,max)). In the trained aging men, the W(aer,max) was higher than in the sedentary group of matching age [mean (SD) 206.8 (17.1) W versus 136.6 (12.3) W; P<0.0001]. The fat percentage was higher in the sedentary (n = 9) than in the trained (n = 8) group [23.9 (3.2)% versus 14.6 (3.7)%; P<0.0001]. DHEAS and IGF-1 levels were higher in trained than in sedentary subjects, respectively 2.04 (1) micromol/l versus 1.01 (0.68) micromol/l (P=0.02) and 192.1 (40.1) ng/ml versus 132.8 (31.2) ng/ml (P= 0.003). Insulin levels were higher in sedentary subjects [11.2 (3.5) mIU/l versus 7.6 (2.2) mIU/l, P=0.03]. No statistical difference was observed between both groups for FT and total TT values, FSH values and LH values. IGF-1 was correlated with W(aer,max) (r = 0.64, P = 0.003), and DHEAS was correlated with IGF-1 (r=0.59, P=0.01). We observed a relationship between fat percentage and each of the following hormones: IGF-1 (r=-0.50, P=0.03), FT (r=-0.66, P= 0.002), TT (r=-0.54, P = 0.02) and insulin (r=0.63, P=0.004). Insulin was inversely correlated with FT (r= -0.66, P=0.002) and TT (r=-0.47, P=0.05). These results suggest that regular physical activity could maintain higher DHEAS and IGF-1 and lean body mass levels in elderly men, and participate in general well being in older age.

Growth hormone therapy in elderly people: an age-delaying drug?

The aims of this review are to present a brief overview of growth hormone (GH) physiology and to summarize the studies of GH treatment in adults. Special attention has been paid to randomized controlled trials. Studies have revealed a partial deficiency of GH secretion in the elderly. GH secretion on the average declines by 14% with each decade in normal adults after 20 years of age. Aging has a central effect on the GH secretion and peripheric effect on insulin-like growth factor 1 (IGF-1) through changes in the body composition. GH administration may attenuate several important decrements in body composition and in function associated with aging. GH may also have very potent anabolic effects in surgical situations. Short-term side-effects of GH therapy include edema, carpal tunnel syndrome and arthralgia. A number of agents such as oral GH-releasing peptides (GHRPs) increase GH secretion; they may be an alternative to GH treatment in the future. Further studies of GH replacement are needed, examining issues such as dosage, tolerance and efficacy before the widespread use of GH in the elderly is advocated.

[Atrial natriuretic factor and brain natriuretic peptide. Variations in elderly subjects with heart failure]. / Facteur atrial natriurétique et brain natriuretic peptide. Variations chez le sujet âgé en insuffisance cardiaque.

Atrial natriuretic factor (ANF) is a peptide hormone secreted by the atria in response to increased transmural pressure. This peptide is the first of a series of natriuretic hormones which also includes brain natriuretic peptide (BNP). It is destroyed mainly by an ubiquitous enzyme, neutral endopeptidase (NEP). Its main actions are vasodilatation and natriuresis. It is the main physiological agonist of the renin/angiotensin/aldosterone system. In elderly subjects free of cardiovascular disease, baseline concentrations are higher than in younger subjects. In patients with congestive heart disease (CHD), the level of ANF rises due to permanent increased filling pressures. Both atrial and ventricular secretion increase ANF levels which loose their day/night rhythm. ANF is a risk factor independent of mortality, rhythm disorders and acute heart failure in patients with heart failure. BNP is also raised in CHD. There is an inverse correlation between concentration and severity of left ventricule dysfunction. There has been little work on ANF in elderly subjects with CHD. ANF is elevated in these patients and is an independent risk factor for cardiac decompensation. In addition, in very elderly subjects where the diagnosis of CHD is difficult and echocardiography not always possible, assay of BNP could be an interesting diagnostic tool. Currently work on therapeutic possibilities (administration of exogenous ANF, combinations with NEP inhibitor/conversion enzyme inhibitor, ANF/diuretics) have revealed certain problems (short half life of ANF, transient effects, non-specific activity of NEP). The usefulness of ANF and BNP in heart failure in elderly subjects will undoubtedly lie in its capacity to mark disease severity and as a diagnostic tool, particularly in case of acute dyspnoea.