Stepping into adulthood: the transition period.

Area of Science:

• Pediatric Endocrinology
• Adolescent Medicine
• Growth Hormone Research

Background:

• The transition period (late puberty to full adult maturation) is critical for achieving peak bone and muscle mass.
• Growth hormone (GH) treatment is often discontinued in adolescents with growth hormone deficiency (GHD) upon reaching final height.
• This discontinuation may lead to more severe outcomes for childhood-onset GHD patients compared to adult-onset GHD.

Purpose of the Study:

• To examine the consequences of discontinuing GH treatment in adolescents with GHD.
• To discuss the timing of GHD retesting and GH treatment resumption in adolescents.
• To highlight the transition period as a key time for modifying GH dosages.

Main Methods:

• Review of recent studies on the effects of GH treatment cessation.
• Analysis of clinical practices regarding GHD management in adolescence.
• Consideration of data from patient registries and clinical treatment experiences.

Main Results:

• Discontinuing GH treatment at final height can attenuate bone and muscle maturation.
• Patients may develop cardiovascular risk factors typically associated with adult GHD.
• Many adolescents may not meet adult criteria for severe GHD, complicating treatment decisions.

Conclusions:

• The transition period is an opportune time to adjust GH dosages for patients with GHD.
• Further investigation into GHD management during adolescence is warranted.
• Utilizing registry data can enhance understanding of GH treatment in pediatric and adult populations.