Altered growth hormone, cortisol, and leptin secretion in healthy elderly persons with sarcopenia and mixed body composition phenotypes

Debra L. Waters, Clifford R. Qualls, Richard I. Dorin, Johannes D. Veldhuis, Richard N. Baumgartner

Research output: Contribution to journalArticlepeer-review

58 Scopus citations


Background. Obese phenotypes and aging are independently associated with hypothalamic-pituitary-adrenocortical (HPA) axis and leptin secretion alterations. However, leptin secretion and HPA axis function in elderly persons with other body composition phenotypes is largely unknown. Methods. Forty-five healthy elderly participants were classified normal lean (NL), sarcopenic (SS), sarcopenic-obese (SO), or obese (OO) using dual-energy x-ray absorptiometry. Growth hormone (GH), cortisol, and leptin secretion were evaluated during a free-running night, and oral glucocorticoid suppression test (dexamethasone DEX). Diurnal cortisol secretion was assessed by hourly salivary samples with timed meals. Data were analyzed using cluster, deconvolution, and approximate entropy (ApEn) analyses. Results. GH area, total secretion, and mean concentration during the free-running night was lower in the SO and OO groups verses the SS and NL groups (p < .02, Wilcoxon test). GH mean concentration and total secretion significantly increased in all groups during DEX (overall p < .05) except the SO group, in which ApEn increased (p = .03). Pre- and postbreakfast peak salivary cortisol (p = .004) and area under the curve (p = .03) was greatest in the SS group. Baseline leptin (11:00 PM) was significantly higher in the SO, OO, and SS groups verses the NL group (p = .01). Appendicular skeletal muscle mass was independently and negatively correlated with leptin in all groups, even after adjusting for percentage body fat (p = .001). Conclusions. In the presence of obesity, GH secretion was depressed with a blunted and disorderly response to oral glucocorticoid suppression in SO participants. Sarcopenic participants had concomitantly elevated leptin and cortisol relative to their low body fat mass. Complex or dysregulated neuroendocrine feedback systems appear to be operating in elderly persons with specific body composition phenotypes.

Original languageEnglish (US)
Pages (from-to)536-541
Number of pages6
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Issue number5
StatePublished - May 2008


  • Aging
  • HPA axis
  • Leptin
  • Sarcopenia

ASJC Scopus subject areas

  • General Medicine


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