[Considerations of growth hormone treatment during the transition from adolescence to adulthood]

Growth hormone (GH) replacement treatment in adults with severe growth hormone deficiency is based on its known effects on body composition, physical performance, bone and lipid metabolism, and on improvements in the quality of life. These features must be taken into consideration when planning GH treatment of patients who are in the transition phase (aged between 15 and 25 years), because developmental stages may vary. GH deficiency during the transition phase is defined as GH levels under 6 microg/l in a standard stimulation test, compared to < 10 microg/l during childhood and < 3 microg/l during adulthood. We present an overview of the diagnostic strategies recommended at international consensus conferences on the verification of GH deficiency during the transition phase. In analogy to the GH treatment of adults, the dosaging (dose at start = 0.2 - 0.5 mg/day) should be based on individual requirements as well as IGF-I concentrations in blood (> 1.0 SDS or < 2.0 SDS). GH treatment during the transition phase should be monitored by an endocrinologist with expertise in dealing with adolescent and adult patients, as well as having experience in structuring treatment and documentation.