Zusammenfassung
Eine große Anzahl von Studien weist auf die signifikante Reduktion der Wachstumshormonsekretion und der damit zusammenhängenden IGF-1-Plasmaspiegel während des menschlichen Alterungsprozesses hin. Diese Veränderungen gehen einher mit der Erniedrigung von Muskelmasse, Knochenmasse, Vitalität und dem Verlust von anderen wichtigen physiologischen Funktionen. Es finden sich ferner Verschlechterungen mentaler und kognitiver Funktionen und das gehäufte Auftreten einer erhöhten altersbedingten Fragilität. Außerdem nimmt das Risiko für Übergewicht und Adipositas zu. Diese Veränderungen sind begleitet von Insulinresistenz, Diabetes Typ 2 und kardiovaskulären Komplikationen. In dieser Arbeit werden die Wirkungen der Wachstumshormontherapie und ihre Bedeutung für die Präventionsmedizin, speziell für die verbesserte Lebensqualität, den Anstieg der Körpermagermasse, einhergehend mit einer Verminderung der abdominalen Fettmasse, und die deutlich verbesserte Skelett- und Muskelfunktion dargestellt. Im Zusammenhang damit stehen der Schutz vor dem kardiometabolischen Syndrom, ein durch rhGH normalisierter Blutdruck, eine Verminderung thrombotischer Marker sowie eine normalisierte endotheliale Funktion. Insgesamt kann demonstriert werden, dass die rhGH-Anwendung als ein hervorragendes Instrument in der Altersprävention geeignet sein könnte. Eine unabdingbare Voraussetzung ist, dass die Auswahl der Patienten nach klaren Kriterien erfolgt. Das bedeutet, dass die Indikationsstellung sich nach dem Ziel der Therapie, dem Ausschluss bekannter Risiken und Nebenwirkungen, dem Alter und möglichen Interaktionen mit anderen Therapien richten sollte.
Résumé
De nombreuses études indiquent que le processus de vieillissement humain inclut une réduction significative de la sécrétion dʼhormone de croissance en association avec une réduction correspondante du taux plasmatique dʼIGF-1. Ces changements sont accompagnés dʼune réduction de la masse musculaire, de la masse osseuse et de la vitalité ainsi que dʼune perte dʼautres fonctions physiologiques importantes. On trouve en outre un déclin des fonctions mentales et cognitives et une incidence accrue de fragilisation due à lʼâge. Le risque de surpoids et dʼobésité augmente également. Ces changements sont associés à une insulinorésistance, au diabète de type 2 et aux complications cardio-vasculaires. Le présent travail décrit les effets du traitement par lʼhormone de croissance et leur signification en médecine préventive, notamment pour améliorer la qualité de vie, augmenter de la masse corporelle avec réduction de la masse grasse abdominale et considérablement améliorer les fonctions musculo-squelettiques. Ces effets sont associés à une prévention du syndrome cardio-métabolique, à une tension artérielle normalisée par la rhGH, à une réduction des marqueurs thrombotiques et à une normalisation de la fonction endothéliale. Globalement, on peut démontrer que lʼadministration de rhGH pourrait être un excellent instrument dans la prévention des problèmes liés au vieillissement. Une condition première est la sélection des patients selon des critères précis. Cela signifie que lʼindication doit être établie avec prise en compte de lʼobjectif thérapeutique visé, de lʼexclusion des risques et effets indésirables, de lʼâge du patient et des interactions possibles avec dʼautres traitements.
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Dieser Beitrag wird auch im Journal für Gynäkologische Endokrinologie/Österreich 2018, https://doi.org/10.1007/s41974-018-0058-4, veröffentlicht
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Klentze, M. Der Effekt von Wachstumshormon auf die menschlichen Alterungsprozesse. Teil 1. J. Gynäkol. Endokrinol. 21, 76–84 (2018). https://doi.org/10.1007/s41975-018-0055-z
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DOI: https://doi.org/10.1007/s41975-018-0055-z
Schlüsselwörter
- Dwarf Mouse Model
- Adipositas
- Kardiometabolisches Syndrom
- Osteopenie
- Wachstumshormonmangel beim Erwachsenen (AGDH)