Somatotropic Axis in Human Aging

During the human aging, GH/IGF-I axis gradually and physiologically declines its activity (somatopause), playing a protective role for age-related disease, particularly neoplastic. Somatopause symptoms of body change during aging overlap with the symptoms of the elderly GHD, which represent a different scenario and has to been investigated in the correct clinical context. GHD in elderly is a clinical syndrome, characterized by a wide array of symptoms, as decrease of lean body mass, exercise capacity, mass and strength of muscle, cardiac performance and BMD, increase of weight and body fat mass, poor sleep and impaired sense of well-being. All these conditions can implicate several and important chronic complications, such as cardiovascular disease, increased risk of fracture rates, which may be responsible for an increased mortality and elderly GHD patients may benefit clinically for replacement treatment with rhGH, that has to be prescribed in medical center with a large experience on pituitary disease and that required a careful management at prescription and during follow-up. Similarly to GHD, also GH excess condition, as acromegaly, can occur in elderly, being associated with an increased morbidity and mortality and requiring so a proper diagnosis and management.