Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: Dr Blackman and colleagues1 found that addition of testosterone to GH administered
to elderly men marginally increased their muscle strength and maximum oxygen
uptake, compared with placebo or to GH alone, both of which did not provide
benefit. I believe, however, that the authors underestimated the true diabetogenic
effects of GH, because they compared the occurrence of diabetes and glucose
intolerance against that for men who had received testosterone only. The appropriate
comparison would have been the placebo group, in which there were half the
number of cases as in the group receiving testosterone only. In addition,
more than half of the men receiving GH developed abnormal glucose metabolism
during the 26 weeks of this study. From the authors' description it is not
clear whether the risk of these events increased over time, or whether most
of them occurred soon after therapy was initiated. The latter would suggest
a worsening in insulin sensitivity over time.
Malozowski S. Use of Growth Hormone in Elderly IndividualsUse of Growth Hormone in Elderly Individuals. JAMA. 2003;290(4):462. doi:10.1001/jama.290.4.462-a