Growth Hormone Therapy in Adults

ABSTRACT
Adult growth hormone deficiency (GHD) has come to be accepted as a clinical syndrome (or nearly past 10 years. Based on increasing evidence that adults with GHD have impaired health, many countries have already approved the use of growth hormone (GH) for adults in GHD. in adults the goals are to restore normal body composition, improve muscle and cardiac function, normalize serum lipid concentrations, and improve the quality of life. GH has been administered not only to adults of all ages with GHD, but also to adults with catabolic illnesses, such as burn injuries, and to older adults with decreased GH secretion. However, studies in adults without growth hormone deficiency are limited. Growth hormone research society (GHRS) agreed that, the diagnosis of GHD should be based on a single abnormal provocative test of growth hormone secretion (insulin - induced hypoglycemia test - ITT) performed and serum levels of insulin Iike growth factor - 1 may be of diagnostic value. Severe GHD is defined by a peak GH response to hypoglycaemia of less than 3 ug/L. GHRS recommended that therapy should start with a low dose, 0.15 - 0.30 mg/day (0.45 - 0.90 IU/day). The dosage should be increased gradually on the basis of clinical and biochemical responses {insulin like growth factor - 1) and no more frequently that at monthly intervals. The maintenance dose may vary from person to person and seldom exceeds 1.0 mg/day (3 IU/day). It is now shown that growth hormone replacement therapy (GHRT) can normalize body composition, increase bone mineral content and decrease cardiovascular risk parameters in adults. GHRT may also improve left ventricular performance and exercise capacity, increase muscle strength and improve well-being and quality of life. GHRT can be cost effective, safe and beneficial.