Document Detail


Growth hormone deficiency in the transition adolescent: should treatment be continued in adult life?
MedLine Citation:
PMID:  11964018     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Adults with growth hormone (GH) deficiency (GHD) have impaired health, which improves with GH replacement. GHD in adulthood leads to impairment in body composition and structure functions as well as to deranged lipoprotein and carbohydrate metabolism leading to increased cardiovascular morbidity. Therefore the transition adolescent in whom severe GHD is confirmed has to continue GH replacement with an appropriate age-related dosage. All short children who have been treated with rhGH for classical and non-classical GHD should be suspected as potentially GHD in adulthood though only in classical organic and idiopathic forms is severe GHD likely to be confirmed. GHD must be shown biochemically by single provocative testing. Insulin-induced hypoglycemia (ITT) and GHRH + arginine are the tests of choice provided that appropriate cutoff limits are assumed; these tests show good specificity and sensitivity. Testing with GHRH + GH secretagogues is another reliable alternative. Low IGF-I levels can be definitive evidence of persistent severe GHD in patients with genetic GHD or panhypopituitarism, but normal IGF-I levels do not rule out severe GHD. Individual titration of the rhGH dose is recommended and measurement of IGF-I levels is needed for monitoring the adequacy of replacement. The mean GH dose for replacement in the transition adolescent, however, is still higher than in adulthood; after puberty the rhGH dose should be progressively decreased in the following years (probably up to 25 years old) in order to obtain optimal peak bone mass.
Authors:
G Aimaretti; G Corneli; S Bellone; C Baffoni; F Camanni; E Ghigo
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Journal of pediatric endocrinology & metabolism : JPEM     Volume:  14 Suppl 5     ISSN:  0334-018X     ISO Abbreviation:  J. Pediatr. Endocrinol. Metab.     Publication Date:  2001  
Date Detail:
Created Date:  2002-04-19     Completed Date:  2002-05-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9508900     Medline TA:  J Pediatr Endocrinol Metab     Country:  England    
Other Details:
Languages:  eng     Pagination:  1233-42; discussion 1261-2     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, University of Turin, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Disease Progression
Growth Hormone / adverse effects,  therapeutic use*
Human Growth Hormone / deficiency*
Humans
Chemical
Reg. No./Substance:
12629-01-5/Human Growth Hormone; 9002-72-6/Growth Hormone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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