Growth hormone (GH) secretion decreases progressively after mid-puberty in
both men and women. This decrease occurs predominantly before age 40-50 and
affects both daytime and nocturnal GH secretion. A reduction in the amplit
ude of GH secretory pulses accounts for the majority of the reduction in GH
secretion. With aging, changes in hypothalamic function may occur that res
ult in decreased GH secretion. These changes may include decreased secretio
n of GH-releasing hormone and/or the putative natural ligand for the GH sec
retagogue receptor or an increase in somatostatin release. Multiple physiol
ogical factors have been reported to regulate GH secretion including sleep,
body composition (% body fat and amount of abdominal visceral fat), aerobi
c physical fitness and serum concentrations of insulin-like growth factor-I
(IGF-I), gonadal steroids and insulin. Changes in these factors with aging
may contribute to the reduction in GH secretion observed in older adults.
However, these physiological predictors of GH secretion are not independent
of one another and the relative importance of these factors in the regulat
ion of GH secretion is not known. Preliminary evidence suggests that the am
ount of abdominal visceral fat and fasting serum concentrations of insulin
and IGF-I are the most important predictors of 24-hour GH release in health
y adults, independent of age and gender. Bi-directional feedback between th
ese three factors and GH secretion may account for the strong relationships
observed.