Adult growth hormone deficiency: current concepts

Area of Science:

• Endocrinology
• Metabolic Disorders
• Clinical Medicine

Background:

• Adult Growth Hormone Deficiency (AGHD) is a recognized clinical syndrome.
• Key features include altered body composition, dyslipidemia, insulin resistance, and reduced quality of life (QoL).
• Psychological well-being is often impaired in patients with AGHD.

Purpose of the Study:

• To review the clinical features and diagnostic methods for AGHD.
• To describe the effects of growth hormone (GH) therapy in adult patients.
• To discuss diagnostic criteria and therapeutic approaches for AGHD.

Main Methods:

• Review of clinical features and diagnostic standards for AGHD.
• Discussion of the insulin tolerance test (ITT) as a gold standard.
• Focus on the GHRP-2 test as a convenient diagnostic tool in Japan, with a cut-off of 9 μg/L for severe AGHD.

Main Results:

• GH therapy has been approved for severe AGHD in Japan since 2006.
• Recommended therapy involves low-dose initiation (3 μg/kg/day) with individualized titration.
• Monitoring includes clinical status and serum IGF-I levels; mortality reduction effects are under investigation.

Conclusions:

• AGHD diagnosis and management have evolved, with specific tests like GHRP-2 utilized in Japan.
• GH replacement therapy offers benefits for adults with AGHD, improving various clinical parameters.
• Further research is needed to confirm the impact of GH treatment on long-term mortality.