medicina58巻9号

2021年08月発行

特集 日常診療で内分泌疾患を見逃さない！ Clinical Question

高齢者において成長ホルモン分泌不全や性ホルモン分泌不全を検索・治療する意義はありますか？

著者： 星野良朋¹ 竹下彰¹

所属機関： ¹虎の門病院内分泌代謝科

ページ範囲：P.1454 - P.1457

Answer
間脳下垂体疾患の既往があれば成長ホルモン分泌不全症を，また性腺機能低下症の症状を有する男性では性ホルモン分泌不全を評価する．禁忌を除外し，適応があれば副作用に注意してホルモン補充療法を行うことは有益である．

参考文献

1）Götherström G, et al：Muscle strength in elderly adults with GH deficiency after 10 years of GH replacement. Eur J Endocrinol 163：207-215, 2010

2）Gill MS, et al：Serum leptin response to the acute and chronic administration of growth hormone（GH）to elderly subjects with GH deficiency. J Clin Endocrinol Metab 84：1288-1295, 1999

3）Fernholm R, et al：Growth hormone replacement therapy improves body composition and increases bone metabolism in elderly patients with pituitary disease. J Clin Endocrinol Metab 85：4104-4112, 2000

4）White HD, et al：Growth hormone replacement is important for the restoration of parathyroid hormone sensitivity and improvement in bone metabolism in older adult growth hormone-deficient patients. J Clin Endocrinol Metab 90：3371-3380, 2005

5）Elgzyri T, et al：The effects of GH replacement therapy on cardiac morphology and function, exercise capacity and serum lipids in elderly patients with GH deficiency. Clin Endocrinol（Oxf） 61：113-122, 2004

6）Franco C, et al：Baseline characteristics and effects of growth hormone therapy over two years in younger and elderly adults with adult onset GH deficiency. J Clin Endocrinol Metab 91：4408-4414, 2006

7）Monson JP, et al：Growth hormone deficiency and replacement in elderly hypopituitary adults. KIMS Study Group and the KIMS International Board. Pharmacia and Upjohn International Metabolic Database. Clin Endocrinol（Oxf） 53：281-289, 2000

8）Koltowska-Häggström M, et al：Assessment of quality of life in adult patients with GH deficiency；KIMS contribution to clinical practice and pharmacoeconomic evaluations. Eur J Endocrinol 161 （Suppl 1）：S51-64, 2009

9）Molitch ME, et al：Evaluation and treatment of adult growth hormone deficiency；An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96：1587-1609, 2011

10）Liu JT, Su PH：Amelioration of cognitive impairment following growth hormone replacement therapy；A case report and review of literature. World J Clin Cases 8：5773-5780, 2020

11）Fleseriu M, et al：Hormonal replacement in hypopituitarism in adults；An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 101：3888-3921, 2016

12）Kokshoorn NE, et al：GH replacement therapy in elderly GH-deficient patients；A systematic review. Eur J Endocrinol 164：657-665, 2011

13）Yabluchanskiy A, Tsitouras PD：Is testosterone replacement therapy in older men effective and safe? Drugs Aging 36：981-989, 2019

14）Mohler ER, et al：The effect of testosterone on cardiovascular biomarkers in the Testosterone Trials. J Clin Endocrinol Metab 103：681-688, 2018

15）Bhasin S, et al：Testosterone therapy in men with hypogonadism；An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 103：1715-1744, 2018

16）Snyder PJ, et al：Effects of testosterone treatment in older men. N Engl J Med 374：611-624, 2016

17）Lisco G, et al：Age-related male hypogonadism and cognitive impairment in the elderly；Focus on the effects of testosterone replacement therapy on cognition. Geriatrics（Basel） 5：76, 2020

18）日本泌尿器科学会，日本Men's Health医学会（編）：加齢男性性腺機能低下症候群（LOH症候群）診療の手引き，じほう，2007

19）Morales A, Lunenfeld B：Investigation, treatment and monitoring of late-onset hypogonadism in males. Official recommendations of ISSAM. International Society for the Study of the Aging Male. Aging Male 5：74-86, 2002

20）Juul A, Skakkebaek NE：Androgens and the ageing male. Hum Reprod Update 8：423-433, 2002

21）Lobo RA：Hormone-replacement therapy；Current thinking. Nat Rev Endocrinol 13：220-231, 2017

22）日本産科婦人科学会，日本女性医学学会（編）：ホルモン補充療法ガイドライン2017年版，日本産科婦人科学会，2017

23）Rossouw JE, et al：Risks and benefits of estrogen plus progestin in healthy postmenopausal women；Principal results from the Women's Health Initiative randomized controlled trial. Jama 288：321-333, 2002