Growth hormone replacement in adults – Current standards and new perspectives

Publication date: Available online 2 October 2014 Source:Best Practice & Research Clinical Endocrinology & Metabolism Author(s): Charlotte Höybye , Jens Sandahl Christiansen Growth hormone deficiency (GHD) in adults is an established clinical syndrome characterised by adverse body composition with more body fat than lean body mass, unfavourable blood lipids, decreased physical fitness and poor quality of life. No specific biomarker for GHD exists and the sometimes difficult diagnosis should be made in accordance with, established guidelines. Measurements of insulin-like growth factor I (IGF-I) is often not sufficient for the diagnosis and stimulation tests of the GH reserve are required. After diagnosis of GHD, treatment with GH should be initiated with a low dose, and gradually increased aiming at obtaining an IGF-I level within the upper part of the normal range for age matched healthy controls. Most side effects are mild and transient and attenuated by gradual dose increments. Numerous studies have shown that GH treatment can improve body composition, cardiovascular risk factors, physical capacity and quality of life. However, studies on effects beyond 5 years are few and despite encouraging preliminary reports the ultimate endpoint demonstrating that GH treatment has beneficial effects on mortality, cardiovascular events and fractures without an increase in cancer incidence remain to be solidly demonstrated and studies to resolve these issues are aw...
Source: Best Practice and Research Clinical Endocrinology and Metabolism - Category: Endocrinology Source Type: research