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Growth Hormone & IGF Research :... Apr 2024Hormonal substitution with growth hormone in aged patients remains a debated research topic and is rarely initiated in clinical practice. This reluctance may originate... (Review)
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.
Topics: Aged; Humans; Comorbidity; Growth Hormone; Human Growth Hormone; Insulin-Like Growth Factor I; Quality of Life; Randomized Controlled Trials as Topic; Aging
PubMed: 38489867
DOI: 10.1016/j.ghir.2024.101584 -
PloS One 2022Idiopathic short stature (ISS) describes a heterogeneous group of children of many unidentified causes of short stature presently without definitive therapy. Chinese... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Idiopathic short stature (ISS) describes a heterogeneous group of children of many unidentified causes of short stature presently without definitive therapy. Chinese herbal medicine (CHM) is an alternative and complementary treatment for children with ISS and has been widely used for ISS while the evidence of its effectiveness is controversial. We conducted this systematic review and meta-analysis in order to evaluate the efficacy of CHM for ISS.
METHODS
PubMed, Embase, Web of science, Sino-Med, Cochrane, CNKI, VIP, and Wangfang Data were electronically searched to collect randomized controlled trials (RCTs) of CHM treatment of ISS from inception to May 2021. Two researchers independently scanned the literature and extracted information on general characteristics, including patient, study design, interventions, and side effects, assessing the CHM intervention's efficacy and the risk of bias. Height, bone age, growth velocity, and IGF-1 level are the main consequences. Height standard deviations score (HtSDS), change in HtSDS (ΔHtSDS), osteocalcin, the peak level of growth hormones (GHP), and predicted adult height (PAH) are the secondary outcomes. Meta-analysis was then performed by using RevMan 5.3 (Cochrane Collaboration).
RESULTS
Seven articles (569 participants) were included. The Meta-analysis indicated that herbal medicine was associated with increased height (MD 2.16 points; 95%CI, 0.22 to 4.10; P = 0.03), growth velocity (MD 1.47 points; 95%CI, 0.28 to 2.67; P = 0.02), IGF-1 level (MD 28.13 points; 95%CI, 22.80 to 33.46; P<0.00001) and GHP (MD 3.29 points; 95%CI, 1.54 to 5.04; P = 0.0002).
CONCLUSION
According to current research, CHM appears to be useful for children with ISS. Due to the limited quality and number of studies included, more high-quality studies are needed to corroborate the above conclusions.
Topics: Adult; Child; Drugs, Chinese Herbal; Humans; Insulin-Like Growth Factor I; Phytotherapy
PubMed: 35749540
DOI: 10.1371/journal.pone.0270511 -
Journal of Psychiatric Research Jan 2024Leptin and insulin-like growth factor-1 (IGF-1) may play a role in clinical identification of post-stroke depression (PSD). Here, eight databases (including CNKI,... (Meta-Analysis)
Meta-Analysis Review
Leptin and insulin-like growth factor-1 (IGF-1) may play a role in clinical identification of post-stroke depression (PSD). Here, eight databases (including CNKI, Wanfang, SinoMed, VIP, PubMed, the Cochrane Library, Embase, and the Web of Science) were employed to search for studies on serum leptin and insulin-like growth factor-1 expression levels in patients with PSD. In total, 13 articles were included, of which 6 studies investigated the expression level of serum leptin in patients with PSD, 7 studies explored the serum IGF-1 in PSD patients. Then, the RevMan 5.4 software was used for meta-analysis. The results showed that serum leptin levels were significantly higher in PSD patients than in patients without PSD (SMD = 1.54, 95% CI: 0.84, 2.23; P = 0.006). The result of subgroup analysis showed that the serum leptin levels in PSD patients were significantly higher than those without PSD in acute phase (SMD = 1.38, 95% CI: 0.04, 2.71; P = 0.04), subacute phase (SMD = 2.31, 95% CI: 0.88, 3.73; P = 0.001), and chronic phase (SMD = 1.02, 95% CI: 0.43, 1.60; P = 0.0007); There was no significant difference in serum IGF-1 level between PSD patients and patients without PSD (SMD = 0.49, 95% CI: -0.55, 1.52; P = 0.36). Moreover, the subgroup analysis also showed that there was no statistical difference in acute stage (SMD = 0.36, 95% CI: 0.89, 1.60; P = 0.57). Our study provides evidence to prove that serum leptin level has potential clinical application value as biomarkers for identifying PSD.
Topics: Humans; Biomarkers; Depression; Insulin-Like Growth Factor I; Insulin-Like Peptides; Leptin; Stroke
PubMed: 38091723
DOI: 10.1016/j.jpsychires.2023.12.006 -
Frontiers in Endocrinology 2021Xanthomatous hypophysitis (XHP) is an extremely rare form of primary hypophysitis for which there is a lack of clinical experience. A comprehensive understanding of its...
PURPOSE
Xanthomatous hypophysitis (XHP) is an extremely rare form of primary hypophysitis for which there is a lack of clinical experience. A comprehensive understanding of its clinical characteristics, diagnosis and treatment is needed.
METHODS
Here, we report a case study and conduct a systematic review of XHP. Thirty-six cases were included, and their clinical manifestations, endocrine assessment, imaging features, treatment and follow-up data were collected and analyzed.
RESULTS
The mean age at diagnosis was 39.1 years, and females were predominant (75.0%). The most common symptom was headache (68.6%), and 66.7% of female patients presented menstrual disorders. The most common pituitary dysfunction was growth hormone (GH) deficiency. More than half of patients exhibited central diabetes insipidus (CDI). The majority of patients had an imaging presentation of a cystic lesion with peripheral enhancement. Pituitary stalk thickening was observed in half of the patients. Total lesion resection was achieved in 57.1% of cases. The recurrence rate after partial resection and biopsy was significantly higher than that after total lesion resection (57.1% 0.0%, P = 0.0147). The most common pituitary hormone abnormalities to resolve after surgery were hyperprolactinemia (100.0%) and GH deficiency (91.7%). The typical pathological feature was inflammatory infiltration of foamy histiocytes, which showed positivity for CD68.
CONCLUSION
Diagnosis of XHP is difficult when relying on clinical symptoms and imaging features. Therefore, surgical histopathology is necessary. Based on the available evidence, total lesion resection is recommended for treatment. However, the long-term prognosis for this rare disease remains unclear.
Topics: Adolescent; Adrenocorticotropic Hormone; Adult; Aged; Child; Female; Follicle Stimulating Hormone; Human Growth Hormone; Humans; Hypophysitis; Insulin-Like Growth Factor I; Luteinizing Hormone; Male; Middle Aged; Pituitary Gland; Thyrotropin; Xanthomatosis; Young Adult
PubMed: 34659121
DOI: 10.3389/fendo.2021.735655 -
Phytomedicine : International Journal... Jul 2024Over years, there has been a widespread quest for effective dietary patterns and natural extracts to mitigate prostate cancer risk. However, despite numerous... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Over years, there has been a widespread quest for effective dietary patterns and natural extracts to mitigate prostate cancer risk. However, despite numerous experimental studies conducted on various natural extracts, the evidence substantiating their efficacy remains largely insufficient. This dearth of compelling evidence presents a significant challenge in advocating for their widespread use as preventive measures against prostate cancer.
OBJECTIVE
Our study endeavors to undertake a network meta-analysis to evaluate the influence of natural extracts on prostate cancer.
METHODS
Researchers systematically searched through Embase, PubMed, Cochrane Library, and Web of Science databases until December 2023. The main focus was on assessing primary outcomes comprising prostate-specific antigen (PSA), insulin-like growth factor-binding protein-3 (IGFBP-3), insulin-like growth factor-1 (IGF-1). We conducted data analysis utilizing StataMP 15.0 software. Therapeutic effects were ranked based on the probability values derived from Surface Under the Cumulative Ranking curve (SUCRA). Additionally, cluster analysis was employed to assess the impacts of natural extracts on three distinct outcomes.
RESULTS
Following screening procedures, the 28 eligible studies were incorporated, the selected studies encompassed 1,566 prostate cancer patients and evaluated 16 different natural extract treatments. Specifically, 24 trials included PSA indicators, 10 included IGF-1 indicators, and 8 included IGFBP-3 indicators. The findings revealed that, based on the SUCRA values, the combined therapy of silybin with selenium (74%) appears to be the most effective approach for reducing serum PSA levels. Simultaneously, silybin alone (84.6%) stands out as the most promising option for decreasing serum IGF-1 levels. Lastly, concerning IGFBP-3, silybin alone (67.7%) emerges as the optimal choice. Twelve studies provided comprehensive information on adverse drug reactions/events (ADR/ADE), whereas five articles did not report any significant ADR/ADE.
CONCLUSION
The NMA suggests that, compared to placebo, utilizing silybin either alone or in combination with selenium has been shown to enhance therapeutic effects, offering potential benefits to patients with prostate cancer. This study can offer valuable insights for prostate patients considering natural extract treatments. Further evidence is required to confirm the safety profile of these treatments.
Topics: Male; Prostatic Neoplasms; Humans; Insulin-Like Growth Factor I; Insulin-Like Growth Factor Binding Protein 3; Network Meta-Analysis; Prostate-Specific Antigen; Plant Extracts; Biological Products
PubMed: 38608596
DOI: 10.1016/j.phymed.2024.155598 -
Growth Hormone & IGF Research :... 2021Insulin-like growth factor 1 (IGF-1) is an important factor related to cardiovascular disease. In recent years, studies have shown the involvement of IGF-1 and blood... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Insulin-like growth factor 1 (IGF-1) is an important factor related to cardiovascular disease. In recent years, studies have shown the involvement of IGF-1 and blood pressure (BP). Nevertheless, the results were inconsistent. Thus, the purpose of this study was to systematically evaluate the associations of circulating IGF-1 levels with BP in adults.
METHODS
Two reviewers independently searched and screened articles from the Pubmed, EMBASE, Cochrane Library, CNKI, and WANFANG databases up to May 2020. A total of 12 studies that reported the correlation coefficients between IGF-1, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were included.
RESULTS
IGF-1 was significantly correlated with SBP [r = -0.15; 95% CI = -0.21, -0.08; P < 0.0001] and DBP [r = -0.10; 95% CI = -0.16, -0.05; P = 0.0004]. Subgroup analysis further revealed that the relationship between IGF-1 and BP was influenced by race and age.
CONCLUSION
Circulating IGF-1 was negatively correlated with SBP and DBP. Further researches are necessary to explore the pathogenesis of this relationship and to evaluate the role of IGF-1 in the treatment of hypertension.
Topics: Blood Pressure; Humans; Hypertension; Insulin-Like Growth Factor I; Observational Studies as Topic
PubMed: 34273744
DOI: 10.1016/j.ghir.2021.101416 -
Mechanisms of Ageing and Development Mar 2021Physiological cascades of neurotrophic factors and inflammatory cytokines may mediate the exercise-induced amelioration of cognition in older adults. However, there is... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Physiological cascades of neurotrophic factors and inflammatory cytokines may mediate the exercise-induced amelioration of cognition in older adults. However, there is limited understanding on how different exercise modalities improving cognition alter biomarkers. Our aim was to evaluate the effects of different exercise modalities on blood biomarker concentrations in cognitive clinical trials of older adults.
METHODS
A systematic review (SR) and meta-analysis (MA) were performed using the databases PubMed, EMBASE, and SCOPUS. After exclusions, 17 trials with 18 distinct exercise interventions were included.
RESULTS
Aerobic training increased (n = 2) or did not significantly change BDNF (n = 5), and resistance training increased (n = 2) or did not significantly change (n = 2) IGF-1. Multimodal training significantly increased (n = 1) or did not change (n = 3) BDNF. Interventions that recruited sex-specific cohorts showed an advantage in males for blood marker concentrations and cognitive performance outcomes (n = 3) compared to females (n = 3). Only one of three interventions decreased concentrations of CRP. Eight studies examining BDNF changes were suited for MA and showed that higher BDNF concentrations were reached post intervention, although not reaching statistical significance (p = .26, I = 44 %).
DISCUSSION
Our results suggest that exercise has potential to ameliorate cognitive decline in older adults with divergent, modality-specific, neurotrophic mechanisms.
Topics: Age Factors; Aged; Aging; Biomarkers; Brain-Derived Neurotrophic Factor; Clinical Trials as Topic; Cognition; Exercise; Exercise Therapy; Female; Healthy Aging; Humans; Inflammation Mediators; Insulin-Like Growth Factor I; Male; Middle Aged; Neurons
PubMed: 33422561
DOI: 10.1016/j.mad.2021.111431 -
BMC Women's Health Dec 2022At present, there are multiple hypotheses regarding the mechanisms underlying the effect of exercise on the postoperative inflammatory factors and the IGF system among... (Meta-Analysis)
Meta-Analysis
BACKGROUND
At present, there are multiple hypotheses regarding the mechanisms underlying the effect of exercise on the postoperative inflammatory factors and the IGF system among breast cancer patients, especially. To determine the underlying mechanisms, prevent the recurrence of breast cancer and improve its prognosis, this paper will systematically evaluate the impact of exercise on inflammatory factors and the IGF system in breast cancer survivors.
METHODS
The PubMed, Embase, Web of Science, CNKI, Wanfang and VIP (Chinese scientific and technical journals) databases were systematically searched until April 2021. The search terms included 'exercise', 'inflammatory factor', 'IGF system' and 'breast cancer'. A total of 1066 relevant articles were retrieved. The articles were screened according to inclusion and exclusion criteria, such as study population, intervention method and type of experiment, and 11 articles were ultimately included. All statistical results were analysed using STATA 14.0 and Rstudio 4.1.1.
RESULTS
We found that exercise significantly reduced the level of IGF-1 (WMD, -19.947 ng/ml; 95% CI, -22.669 to -17.225; P = 0.000). Subgroup analysis showed that in the studies with an intervention period > 12 weeks, exercise significantly reduced IL-6 levels (WMD, -0.761 pg/ml; 95% CI, -1.369 to -0.153; p = 0.014), while in the studies with an intervention period ≤ 12 weeks, exercise significantly reduced CRP (WMD, -2.381 mg/L; 95% CI, -4.835 to 0.073, P = 0.001) and IL-10 levels (WMD, -7.141 pg/ml, 95% CI, -10.853 to -3.428; P = 0.000). In addition, aerobic exercise plus resistance training significantly reduced IL-6 levels (WMD, -1.474 pg/ml; 95% CI, -1.653 to -1.296; P = 0.000). The results of the sensitivity analysis showed that after excluding the studies with high heterogeneity, exercise significantly reduced the TNF-α levels in patients with breast cancer (WMD, -1.399 pg/ml; 95% CI, -1.718 to -1.080; P = 0.000).
CONCLUSION
Exercise reduces the postoperative levels of IGF-1, IL-6, CRP, IL-10 and TNF-α among patients with breast cancer, which may have a significant impact on inhibiting breast cancer recurrence and improving its prognosis. Future studies should examine the effects of different durations and types of exercise to develop individualized exercise prescriptions for breast cancer patients.
Topics: Humans; Cancer Survivors; Exercise; Insulin-Like Growth Factor I; Interleukin-10; Interleukin-6; Tumor Necrosis Factor-alpha; Breast Neoplasms; Female; Inflammation
PubMed: 36482346
DOI: 10.1186/s12905-022-02058-5 -
Revista Da Associacao Medica Brasileira... Sep 2021
Review
Topics: Breast Neoplasms; Case-Control Studies; Female; Gene Expression; Humans; Insulin-Like Growth Factor I; Risk Factors
PubMed: 34816937
DOI: 10.1590/1806-9282.20210220 -
Clinical Nutrition (Edinburgh, Scotland) Jun 2020Calorie restriction (CR) and reductions in protein intake in rodents result in increased lifespan and reduced levels of IGF-1. However, the changes in IGF-1 in humans in... (Meta-Analysis)
Meta-Analysis
Calorie restriction (CR) and reductions in protein intake in rodents result in increased lifespan and reduced levels of IGF-1. However, the changes in IGF-1 in humans in response to CR and elevated protein intake are confused. We conducted a systematic review and meta-analysis to investigate the effect of Calorie restriction (CR) or increase in protein intake on IGF-1 in humans. The systematic review protocols have been developed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. Two separate systematic searches were undertaken: first for the effect of CR and second on the effect of increase in protein intake on IGF-1. PubMed, SCOPUS and ISI Web of Science databases were searched. In the meta-analysis of the calorie restriction studies, twelve studies met the inclusion criteria (8 clinical trials and 4 observational studies). The meta-analysis of both clinical trials and observational studies revealed no significant effect of CR on IGF-1 (clinical trials: standardized mean difference (SMD) = 0.002 ng/ml, 95% CI -0.14 to 0.14 ng/ml, p = 0.98; observational studies (SMD = -1.14 ng/ml, 95% CI -1.9 to -0.38 ng/ml, p = 0.003). In the meta-analysis of protein intake studies (six studies), a significant increase in circulating IGF-1 levels in response to increases in dietary protein was revealed (SMD = 0.4 ng/ml, 95% CI 0.18-0.61 ng/ml, p < 0.001). In conclusion, in humans, CR was not associated with a significant change in circulating IGF-1. However an increase in protein intake was associated with increased levels of circulating IGF-1. PROTOCOLS REGISTRATION NUMBER: CRD42017073149 for the protein intake meta-analysis and CRD42016046260 for CR meta-analysis.
Topics: Adult; Biomarkers; Caloric Restriction; Dietary Proteins; Female; Humans; Insulin-Like Growth Factor I; Male; Middle Aged; Up-Regulation; Young Adult
PubMed: 31431306
DOI: 10.1016/j.clnu.2019.07.030