Testing growth hormone deficiency in adults.

Area of Science:

• Endocrinology
• Metabolic Disorders

Background:

• Adult growth hormone deficiency (GHD) is a recognized clinical syndrome.
• Diagnosis requires biochemical confirmation alongside clinical context.
• Specific patient groups warrant investigation for GHD.

Purpose of the Study:

• To outline the diagnostic criteria and methods for adult GHD.
• To identify patient populations requiring GHD assessment.
• To detail appropriate provocative testing for GHD diagnosis.

Main Methods:

• Clinical assessment for signs of hypothalamic-pituitary disease.
• Biochemical evaluation including IGF-I levels.
• Provocative testing of GH secretory reserve when indicated.

Main Results:

• Patients with multiple pituitary hormone deficiencies and low IGF-I may not need provocative testing.
• The insulin tolerance test is the gold standard for provocative testing.
• Alternative validated tests include GHRH+arginine, GHRH+GH-releasing peptide, and glucagon stimulation tests.

Conclusions:

• Accurate diagnosis of adult GHD relies on integrated clinical and biochemical assessment.
• Provocative testing is crucial for diagnosing GHD in most cases.
• Test selection and interpretation must consider influencing factors like age and BMI.