Evaluation and treatment of adult growth hormone deficiency: an Endocrine Society Clinical Practice Guideline.
OBJECTIVE
The objective is to provide guidelines for the evaluation and treatment of adults with GH deficiency (GHD).


METHODS
The chair of the Task Force was selected by the Clinical Guidelines Subcommittee of The Endocrine Society (TES). The chair selected five other endocrinologists and a medical writer, who were approved by the Council. One closed meeting of the group was held. There was no corporate funding, and members of the group received no remuneration.


METHODS
Only fully published, peer-reviewed literature was reviewed. The Grades of Evidence used are outlined in the Appendix.


METHODS
Consensus was achieved through one group meeting and e-mailing of drafts that were written by the group with grammatical/style help from the medical writer. Drafts were reviewed successively by the Clinical Guidelines Subcommittee, the Clinical Affairs Committee, and TES Council, and a version was placed on the TES web site for comments. At each level, the writing group incorporated needed changes.


CONCLUSIONS
GHD can persist from childhood or be newly acquired. Confirmation through stimulation testing is usually required unless there is a proven genetic/structural lesion persistent from childhood. GH therapy offers benefits in body composition, exercise capacity, skeletal integrity, and quality of life measures and is most likely to benefit those patients who have more severe GHD. The risks of GH treatment are low. GH dosing regimens should be individualized. The final decision to treat adults with GHD requires thoughtful clinical judgment with a careful evaluation of the benefits and risks specific to the individual.
Molitch
Mark E
ME
Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA.
Clemmons
David R
DR
Malozowski
Saul
S
Merriam
George R
GR
Shalet
Stephen M
SM
Vance
Mary Lee
ML
Stephens
Patricia A
PA
D000328:Adult; D002648:Child; D006801:Humans; D017668:Age of Onset; D013006:Growth Hormone / Q000008:administration & dosage / Q000627:therapeutic use; D019382:Human Growth Hormone / Q000172:deficiency; D010900:Pituitary Diseases / Q000175:diagnosis / Q000188:drug therapy
D013006:Growth Hormone; D019382:Human Growth Hormone