Growth hormone therapy in adults

Area of Science:

• Endocrinology
• Metabolic Medicine
• Adult Growth Hormone Deficiency

Background:

• Growth hormone (GH) plays a crucial role in childhood linear growth and maintains vital metabolic functions throughout adulthood.
• Adult GH deficiency (AGHD) presents a distinct syndrome characterized by increased adiposity, reduced muscle mass, impaired aerobic capacity, and adverse lipid profiles.
• AGHD is associated with increased cardiovascular mortality, highlighting the importance of timely diagnosis and management.

Purpose of the Study:

• To review the clinical manifestations and therapeutic implications of adult GH deficiency (AGHD).
• To discuss the diagnostic criteria and biochemical testing for confirming AGHD.
• To evaluate the efficacy and safety of GH replacement therapy in adults with AGHD.

Main Methods:

• Review of existing literature on adult GH deficiency and GH replacement therapy.
• Discussion of diagnostic approaches, including biochemical assessment.
• Analysis of GH dosing strategies and potential side effects, including cancer risk.

Main Results:

• GH replacement therapy in AGHD effectively ameliorates key features of the syndrome, including increased body fat and decreased muscle mass.
• GH therapy improves lipid profiles, aerobic capacity, and potentially reduces cardiovascular risk in AGHD patients.
• Concerns regarding increased cancer risk with long-term GH treatment in AGHD remain, but evidence is not conclusive.

Conclusions:

• Adult GH deficiency should be suspected in patients with a history of childhood GH deficiency or pituitary damage and confirmed via biochemical testing.
• Physiologic GH replacement doses, carefully titrated, are effective in managing AGHD and improving patient outcomes.
• Further research is needed to clarify the long-term safety profile of GH therapy and its role in conditions beyond AGHD.