Effects of an Oral Ghrelin Mimetic on Body Composition and Clinical Outcomes in Healthy Older Adults

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   Figure 1. Study flow diagram.

   FBG= fasting blood glucose; HRT= hormone replacement therapy; MI= myocardial infarction.
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   Figure 2. Growth hormone (GH) and insulin-like growth factor I (IGF-I) levels at baseline and at 6 and 12 months, and a representative GH profile.

   Growth hormone and IGF-I data were not normally distributed and were analyzed on the natural logarithmic scale. Line graphs show geometric means and 95% CIs. Results of growth hormone deconvolution analysis are included in Appendix Table 1. A. Mean 24-hour GH levels. The dashed line indicates 24-hour mean GH level for young men and women combined (~1.3 g/L). *P < 0.001 for MK-677 versus placebo. B. Serum IGF-I levels. The lower dotted line indicates the lower limit of the IGF-I normal range for older adults (59 to 225 g/L), and the upper dashed line indicates the lower limit in adults age 21 to 25 years (116 to 358 g/L). C. Representative 24-hour GH profile in a 70-year-old man with a body mass index of 23.2 kg/m² who received MK-677 for 1 year. His 24-hour mean GH levels were 0.37, 1.0, and 0.86 g/L at baseline, 6 months, and 12 months, respectively. The pulsatile pattern of GH secretion at baseline is maintained and enhanced at 6 and 12 months, primarily because of increased secretion per peak rather than peak frequency.
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   Figure 3. Changes in body composition at 12 months.

   Graphs show arithmetic differences (95% CI). Asterisks indicates a significant difference (MK-677 vs. placebo) at 12 months. 4-C= 4-compartment model; CT= computed tomography; DXA= dual energy x-ray absorptiometry; ECW= extracellular water; FFM= fat-free mass; ICW= intracellular water; SC= subcutaneous; TASM= total appendicular skeletal mass; TBW= total body water. A. Changes in FFM (by 4-C model and by DXA) and TASM (by DXA). B. Changes in TBW, EBW, and ICW. The increase in TBW and ICW with MK-677 are consistent with the anabolic effects of the drug. C. Changes in abdominal visceral and abdominal SC fat cross-sectional areas by computed tomography. D. Changes in body weight and total fat by 4-C model and DXA.
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   Figure 4. Mean changes in fat and fat-free mass (FFM) at 12 months.

   Limb= appendicular lean soft tissue and appendicular fat; nonlimb= total minus limb.