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Abstract
The characteristic changes in human puberty – increased muscle bulk, increased linear
growth, and the mineralization of the skeleton – are due, in part, to the combined
effects of growth hormone (GH), insulin-like growth factor I (IGF-I), sex hormones
and insulin. GH and testosterone, but not oestrogen, are highly protein-anabolic in
vivo, and the combined administration of GH and testosterone has synergistic effects
on these measures, both in children and adults. GH has no significant effect on enhancing
skeletal muscle strength in humans; however, testosterone is highly ergogenic and
is largely responsible for the differences in muscle bulk apparent in late puberty
between the genders. The results of recent detailed metabolic studies suggest that
boys have higher rates of protein synthesis and IGF-I generation than girls, given
comparable doses of GH. In patients with a constitutional delay in growth and maturation,
relative deficiencies in testosterone and lower IGF-I concentrations are associated
with greater rates of total energy expenditure, suggesting that this relatively hormone-insufficient
state is associated with a hypermetabolic state. Whether added nutritional supplements,
alone or in combination with GH, could improve the growth pattern and final height
of these children deserves further study. In conclusion, the metabolic effects of
GH and testosterone are complex and they synergize in puberty. These hormones could
be of use as protein-anabolic agents in selected catabolic conditions.