Monday, July 5, 2010

The diagnosis and treatment of growth hormone deficiency in adults

Current Opinion in Endocrinology, Diabetes & Obesity:
August 2010 - Volume 17 - Issue 4 - p 377–383
doi: 10.1097/MED.0b013e32833b6bc7
Neuroendocrinology: Edited by William H. Ludlam

Clemmons, David R


Purpose of review: This review summarizes the recent published information regarding efficacy and complications of growth hormone replacement therapy. Several recent reports have monitored patients for periods of up to 10 years. Additionally, a consensus conference has been held regarding needed improvements in diagnostic testing and the recommendations of consensus panels regarding diagnostic criteria and laboratory test utilization are summarized.

Recent findings: Long-term studies show growth hormone can be administered safely and that muscle strength and function as well as lipoprotein abnormalities and low-bone mineral density show sustained improvement over extended periods of time. The complications that occur are generally dose-dependent and once attenuated do not tend to recur. Long-term safety studies regarding improvement in cardiovascular mortality and/or worsening prognosis for patients who develop malignancies are available only in the form of observational studies and randomized controlled long-term trial information is not yet available. The studies reported provide a means for clinicians to ascertain the patients who are likely to derive the greatest benefit from growth hormone when the appropriate diagnostic testing and treatment paradigms are utilized.

Summary: The studies that are summarized provide useful information for assessing the response to treatment, selecting patients who are candidates for long-term replacement therapy and for selecting those in whom the need for therapy may need to be reassessed.

© 2010 Lippincott Williams & Wilkin



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