Hau Liu, MD, MBA, MPH; Dena M. Bravata, MD, MS; Ingram Olkin, PhD; Anne Friedlander, PhD; Vincent Liu, MD; Brian Roberts, MD; Eran Bendavid, MD, MPH; Olga Saynina, MA, MBA; Shelley R. Salpeter, MD; Alan M. Garber, MD, PhD; Andrew R. Hoffman, MD
Liu H, Bravata DM, Olkin I, Friedlander A, Liu V, Roberts B, et al. Systematic Review: The Effects of Growth Hormone on Athletic Performance. Ann Intern Med. 2008;148:747-758. doi: 10.7326/0003-4819-148-10-200805200-00215
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Published: Ann Intern Med. 2008;148(10):747-758.
Human growth hormone is reportedly used to enhance athletic performance, although its safety and efficacy for this purpose are poorly understood.
To evaluate evidence about the effects of growth hormone on athletic performance in physically fit, young individuals.
MEDLINE, EMBASE, SPORTDiscus, and Cochrane Collaboration databases were searched for English-language studies published between January 1966 and October 2007.
Randomized, controlled trials that compared growth hormone treatment with no growth hormone treatment in community-dwelling healthy participants between 13 and 45 years of age.
2 authors independently reviewed articles and abstracted data.
44 articles describing 27 study samples met inclusion criteria; 303 participants received growth hormone, representing 13.3 person-years of treatment. Participants were young (mean age, 27 years [SD, 3]), lean (mean body mass index, 24 kg/m2 [SD, 2]), and physically fit (mean maximum oxygen uptake, 51 mL/kg of body weight per minute [SD, 8]). Growth hormone dosage (mean, 36 Âµg/kg per day [SD, 21]) and treatment duration (mean, 20 days [SD, 18] for studies giving growth hormone for >1 day) varied. Lean body mass increased in growth hormone recipients compared with participants who did not receive growth hormone (increase, 2.1 kg [95% CI, 1.3 to 2.9 kg]), but strength and exercise capacity did not seem to improve. Lactate levels during exercise were statistically significantly higher in 2 of 3 studies that evaluated this outcome. Growth hormoneâ€“treated participants more frequently experienced soft tissue edema and fatigue than did those not treated with growth hormone.
Few studies evaluated athletic performance. Growth hormone protocols in the studies may not reflect real-world doses and regimens.
Claims that growth hormone enhances physical performance are not supported by the scientific literature. Although the limited available evidence suggests that growth hormone increases lean body mass, it may not improve strength; in addition, it may worsen exercise capacity and increase adverse events. More research is needed to conclusively determine the effects of growth hormone on athletic performance.
Appendix Table 1.
GH = growth hormone. *Sum may be greater than total number excluded because some studies had multiple reasons for exclusion.
Appendix Table 2.
We used a random-effects model and a weighted mean difference effect size to compare GH-treated and non–GH-treated participants. The black diamond represents the summary effect size for the outcome of interest. Values greater than 0 indicate that results with GH treatment were higher than those without GH treatment. The studies are ordered by mean effect size. *Male. †Female. ‡High-dose group. §Low-dose group.
We used a random-effects model and a weighted mean difference effect size to compare GH-treated and non–GH-treated participants. The black diamond represents the summary effect size for the outcome of interest. Values greater than 0 indicate that results with GH treatment were higher than those without GH treatment. The studies are ordered by mean effect size. 1RM = 1 repetition maximum.
We used a random-effects model and a weighted mean difference effect size to compare GH-treated and non–GH-treated participants. The black diamonds represents the summary effect size for the outcome of interest. Values greater than 0 indicate that results with GH treatment were higher than those without GH treatment. The studies are ordered by mean effect size. RER = respiratory exchange rate; RQ = respiratory quotient. *Low-dose group; data obtained from reference 50. †Low-dose GH. ‡High-dose GH. Data obtained from reference 50. §High-dose GH.
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