title: Diagnosis and treatment of growth hormone deficiency in adults.
abstract: The availability of synthetic recombinant human growth hormone (GH) in potentially unlimited quantities since the 1980s has improved understanding of the many nonstatural effects of GH on metabolism, body composition, physical and psychological function, as well as the consequences of GH deficiency in adult life. Adult GH deficiency is now recognized as a distinct if nonspecific syndrome with considerable adverse health consequences. GH replacement therapy in lower doses than those used in children can reverse many of these abnormalities and restore functional capacities toward or even to normal; if dosed appropriately, GH therapy has few adverse effects. Although some doubts remain about possible long-term risks of childhood GH therapy, most registries of adult GH replacement therapy, albeit limited in study size and duration, have not shown an increased incidence of cancers or of cardiovascular morbidity or mortality.
authors: Division of Endocrinology, Diabetes, and Metabolism, University of Miami Miller School of Medicine, 1400 North West 10th Avenue, Suite 807, Miami, FL 33136, USA.
authors: Atil Y
authors: AY
authors: Kargi
authors: George R
authors: GR
authors: Merriam
mesh_terms: D000328:Adult; D004393:Dwarfism, Pituitary / Q000188:drug therapy*; D019382:Human Growth Hormone / Q000009:adverse effects* / Q000627:therapeutic use*; D006801:Humans
chemical_list: D019382:Human Growth Hormone
references: Eur J Endocrinol. 2007 Jul;157(1):9-18
references: 17609396
references: J Clin Endocrinol Metab. 2004 Oct;89(10):4929-36
references: 15472187
references: Clin Endocrinol (Oxf). 2007 Oct;67(4):598-606
references: 17880406
references: Clin Endocrinol (Oxf). 2001 Apr;54(4):525-32
references: 11318789
references: Lancet. 1990 Aug 4;336(8710):285-8
references: 1973979
references: Eur J Endocrinol. 1996 Nov;135(5):559-67
references: 8980158
references: Horm Metab Res. 1997 Mar;29(3):106-10
references: 9137979
references: J Clin Endocrinol Metab. 2008 Sep;93(9):3416-24
references: 18593773
references: Clin Endocrinol (Oxf). 1992 Nov;37(5):387-97
references: 1486686
references: J Clin Endocrinol Metab. 1998 May;83(5):1615-8
references: 9589665
references: Eur J Endocrinol. 2009 Jan;160(1):17-24
references: 18974232
references: J Clin Endocrinol Metab. 2007 Apr;92(4):1442-5
references: 17284638
references: J Clin Endocrinol Metab. 2011 Jun;96(6):1587-609
references: 21602453
references: Eur J Endocrinol. 2007 Apr;156(4):455-62
references: 17389460
references: Endocr Rev. 2004 Jun;25(3):426-57
references: 15180951
references: Acta Paediatr Suppl. 1997 Nov;423:117-20
references: 9401559
references: Bone. 1996 Jun;18(6):551-7
references: 8805996
references: N Engl J Med. 1962 Jan 4;266:31-5
references: 14038540
references: J Clin Endocrinol Metab. 1994 Mar;78(3):669-74
references: 8126140
references: Endocr Rev. 2006 May;27(3):287-317
references: 16543384
references: J Clin Endocrinol Metab. 1987 Jan;64(1):51-8
references: 3782436
references: J Clin Endocrinol Metab. 1998 Feb;83(2):382-95
references: 9467546
references: Curr Opin Endocrinol Diabetes Obes. 2010 Aug;17(4):377-83
references: 20588115
references: J Clin Endocrinol Metab. 2004 Feb;89(2):662-6
references: 14764778
references: Clin Nutr. 2009 Dec;28(6):597-603
references: 19773097
references: Clin Endocrinol (Oxf). 2009 Mar;70(3):435-8
references: 19236640
references: Eur J Endocrinol. 2007 Apr;156(4):439-47
references: 17389458
references: Clin Endocrinol (Oxf). 1999 Nov;51(5):565-73
references: 10594517
references: J Clin Endocrinol Metab. 1998 Sep;83(9):3184-9
references: 9745423
references: Lancet. 2007 Apr 28;369(9571):1461-1470
references: 17467517
references: J Clin Endocrinol Metab. 1996 Mar;81(3):1169-72
references: 8772595
references: Horm Res. 2007;68 Suppl 5:173-6
references: 18174740
references: J Clin Endocrinol Metab. 1993 Dec;77(6):1658-61
references: 8263155
references: Thyroid. 2008 Dec;18(12):1249-54
references: 19012473
references: J Clin Endocrinol Metab. 2002 Apr;87(4):1743-9
references: 11932310
references: Annu Rev Nutr. 1991;11:393-412
references: 1716449
references: J Clin Endocrinol Metab. 2004 Apr;89(4):1684-93
references: 15070931
references: JAMA. 2007 Sep 26;298(12):1429-38
references: 17895459
references: Clin Endocrinol (Oxf). 2002 Apr;56(4):493-501
references: 11966742
references: Eur J Endocrinol. 2006 Aug;155(2):253-60
references: 16868138
references: J Clin Endocrinol Metab. 2001 Apr;86(4):1518-24
references: 11297577
references: Clin Endocrinol (Oxf). 2002 Dec;57(6):751-9
references: 12460325
references: Clin Endocrinol (Oxf). 1996 Nov;45(5):553-6
references: 8977751
references: Ann Intern Med. 2000 Jul 18;133(2):111-22
references: 10896637
references: Ann Intern Med. 1996 Dec 1;125(11):883-90
references: 8967668
references: Qual Life Res. 1999 Jun;8(4):373-83
references: 10472170
references: Metabolism. 1993 Dec;42(12):1519-23
references: 8246764
references: Endocr Rev. 2010 Jun;31(3):301-42
references: 20086217
references: Clin Interv Aging. 2008;3(1):121-9
references: 18488883
references: Pituitary. 2009;12(2):125-35
references: 18373203
references: Endocr Rev. 2001 Feb;22(1):53-74
references: 11159816
references: J Clin Endocrinol Metab. 2002 Jun;87(6):2725-33
references: 12050241
references: Cancer Treat Rev. 2009 Nov;35(7):616-32
references: 19640651
references: J Clin Endocrinol Metab. 1996 Aug;81(8):2865-73
references: 8768843
references: J Clin Endocrinol Metab. 1999 Aug;84(8):2596-602
references: 10443645
references: Metabolism. 1994 Feb;43(2):199-203
references: 8121302
references: J Clin Endocrinol Metab. 2004 May;89(5):2048-56
references: 15126520
references: J Clin Endocrinol Metab. 1999 Jun;84(6):2013-9
references: 10372703
references: Clin Endocrinol (Oxf). 1995 Aug;43(2):151-7
references: 7554309
references: Metabolism. 1995 Sep;44(9):1126-9
references: 7666785
references: Eur J Endocrinol. 2002 May;146(5):667-72
references: 11980622
references: J Bone Miner Res. 1994 Aug;9(8):1319-26
references: 7976513
references: J Clin Endocrinol Metab. 1996 Mar;81(3):1244-7
references: 8772606
references: Eur J Endocrinol. 2006 Jul;155(1):61-71
references: 16793951
references: Clin Endocrinol (Oxf). 1999 Jun;50(6):703-13
references: 10468941
references: J Clin Endocrinol Metab. 2003 May;88(5):2061-9
references: 12727955
references: J Clin Endocrinol Metab. 1997 Mar;82(3):727-34
references: 9062473
references: Clin Endocrinol (Oxf). 1994 Oct;41(4):511-6
references: 7955461
references: Clin Endocrinol (Oxf). 2004 Sep;61(3):320-6
references: 15355447
references: J Clin Endocrinol Metab. 2007 Dec;92(12):4664-70
references: 17911170
references: J Clin Endocrinol Metab. 2006 Aug;91(8):2926-30
references: 16720652
references: Eur J Endocrinol. 2005 Aug;153(2):257-64
references: 16061832
references: Eur J Endocrinol. 2007 Dec;157(6):695-700
references: 18057375
references: Horm Res. 2004;62(2):84-7
references: 15249739
references: J Clin Endocrinol Metab. 2004 Nov;89(11):5397-401
references: 15531488
references: Clin Endocrinol (Oxf). 1995 Feb;42(2):179-89
references: 7704962
references: J Clin Endocrinol Metab. 1992 Jan;74(1):118-23
references: 1727808
references: J Musculoskelet Neuronal Interact. 2001 Sep;2(1):49-58
references: 15758476
references: J Clin Endocrinol Metab. 1999 Feb;84(2):453-7
references: 10022400
references: Eur J Endocrinol. 2007 Jul;157(1):19-27
references: 17609397
references: J Clin Endocrinol Metab. 1997 Jan;82(1):82-8
references: 8989238
references: J Clin Endocrinol Metab. 2009 Aug;94(8):2702-7
references: 19509104
references: Eur J Endocrinol. 2007 Jun;156(6):637-45
references: 17535863
references: J Clin Endocrinol Metab. 2008 Nov;93(11):4413-7
references: 18697875
references: Clin Endocrinol (Oxf). 1995 Aug;43(2):143-9
references: 7554308
references: Clin Endocrinol (Oxf). 1994 Nov;41(5):639-48
references: 7828353
references: Clin Endocrinol (Oxf). 2006 May;64(5):556-60
references: 16649976
references: J Clin Endocrinol Metab. 1997 Feb;82(2):550-5
references: 9024252
references: Endocr Pract. 2009 Sep-Oct;15 Suppl 2:1-29
references: 20228036
references: Acta Endocrinol (Copenh). 1993 Sep;129(3):201-6
references: 8212984
references: Eur J Endocrinol. 1997 Sep;137(3):240-5
references: 9330587
references: Curr Med Chem. 2007;14(13):1399-407
references: 17584052
references: Endocr Rev. 2009 Apr;30(2):152-77
references: 19240267
references: J Clin Endocrinol Metab. 2004 Mar;89(3):1124-30
references: 15001597
references: J Clin Endocrinol Metab. 2003 Jan;88(1):95-102
references: 12519836
references: J Clin Endocrinol Metab. 2010 Feb;95(2):714-21
references: 19965916
references: J Clin Endocrinol Metab. 1997 Feb;82(2):352-6
references: 9024217
references: Endocr Rev. 1998 Feb;19(1):55-79
references: 9494780
references: Growth Horm IGF Res. 2010 Feb;20(1):8-18
references: 19818658
references: J Endocrinol Invest. 2005;28(5 Suppl):47-51
references: 16114276
references: J Clin Endocrinol Metab. 2002 Feb;87(2):477-85
references: 11836272
references: N Engl J Med. 1989 Dec 28;321(26):1797-803
references: 2687691
references: Curr Opin Endocrinol Diabetes Obes. 2012 Aug;19(4):300-5
references: 22596248
references: Endocr Rev. 1987 May;8(2):115-31
references: 3301316
references: Nat Rev Endocrinol. 2011 Jan;7(1):11-24
references: 20956999
references: J Clin Endocrinol Metab. 2009 Mar;94(3):809-16
references: 19088164
references: N Engl J Med. 1999 Sep 9;341(11):785-92
references: 10477776
references: J Clin Endocrinol Metab. 2002 Apr;87(4):1600-6
references: 11932289
references: Clin Endocrinol (Oxf). 2004 Sep;61(3):360-6
references: 15355453
references: Arch Dis Child. 1974 Nov;49(11):904-5
references: 4441124
references: Lancet. 2001 Feb 10;357(9254):425-31
references: 11273062
references: Eur J Endocrinol. 2009 Nov;161(5):663-9
references: 19734242
references: Clin Endocrinol (Oxf). 2007 Oct;67(4):623-8
references: 17581260
references: J Clin Endocrinol Metab. 2012 Feb;97(2):E213-7
references: 22238393
references: BMJ. 1992 Jan 18;304(6820):173-4
references: 1737165
references: J Clin Endocrinol Metab. 2012 Feb;97(2):416-25
references: 22238382
references: J Clin Endocrinol Metab. 2004 May;89(5):2192-9
references: 15126541
references: Growth Horm IGF Res. 2004 Jun;14 Suppl A:S114-7
references: 15135791
references: Eur J Endocrinol. 2003 Mar;148(3):333-8
references: 12611614
references: Rev Endocr Metab Disord. 2006 Dec;7(4):225-35
references: 17308965
references: Eur J Endocrinol. 2007 Jan;156(1):55-64
references: 17218726
references: Clin Endocrinol (Oxf). 2002 Sep;57(3):363-70
references: 12201829
references: J Clin Endocrinol Metab. 2013 Jan;98(1):352-61
references: 23162104
references: Eur J Endocrinol. 2011 Aug;165(2):217-23
references: 21646285
references: Pituitary. 2010 Jun;13(2):146-53
references: 20037793
references: Lancet. 2000 Sep 30;356(9236):1137-42
references: 11030292
references: Nature. 1963 Aug 31;199:913-5
references: 14079908
references: Circulation. 2003 Nov 25;108(21):2648-52
references: 14623813
references: J Clin Endocrinol Metab. 2002 May;87(5):2067-79
references: 11994342
references: J Clin Endocrinol Metab. 2002 Jul;87(7):3136-41
references: 12107213
references: J Bone Miner Res. 2001 Feb;16(2):398-405
references: 11204440
references: Eur J Endocrinol. 1999 Dec;141(6):595-600
references: 10601962
references: Eur J Endocrinol. 2009 Nov;161 Suppl 1:S51-64
references: 19684056
references: Eur J Endocrinol. 2006 Jul;155(1):79-90
references: 16793953
references: J Clin Endocrinol Metab. 2008 Jun;93(6):2063-71
references: 18381581
references: J Gerontol A Biol Sci Med Sci. 1998 Mar;53(2):B117-24
references: 9520907