Growth hormone and androgen effects in the third decade

Area of Science:

• Endocrinology
• Pediatric Endocrinology
• Growth Hormone Therapy

Background:

• Investigating the efficacy of human pituitary growth hormone (hGH) in adult male hypopituitary dwarfs with delayed skeletal maturation.
• Assessing the impact of hGH monotherapy versus combination therapy with exogenous androgen on growth and body composition.

Observation:

• Patients received hGH alone for 1.7-2.2 years, followed by hGH plus androgen for 3.0-3.1 years.
• hGH alone doubled the height growth rate, but actual growth was limited (2.2-3.5 cm/year).
• Addition of androgen increased growth rate to approximately 8 cm/year, achieving total height gains of 16-17 cm.

Findings:

• hGH treatment alone showed limited growth impact in adult hypopituitary dwarfs.
• Combination therapy with hGH and androgen significantly accelerated linear growth, comparable to normal late maturers.
• Body composition, including arm fat and muscle mass, showed significant changes with both hGH alone and combination therapy.

Implications:

• Androgen is crucial for maximizing the linear growth response to hGH in individuals with hypopituitarism at pubertal bone age.
• This highlights the importance of considering androgen status when initiating growth hormone therapy in this population.
• Optimized therapeutic strategies involving both hGH and androgen can lead to substantial height gains and improved body composition.