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2014 ; 54
(8
): 599-605
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Adult growth hormone deficiency: current concepts
#MMPMID25070016
Fukuda I
; Hizuka N
; Muraoka T
; Ichihara A
Neurol Med Chir (Tokyo)
2014[]; 54
(8
): 599-605
PMID25070016
show ga
The clinical syndrome of adult growth hormone deficiency (AGHD) was widely
recognized in the 1980s. In this review, we first describe the clinical features
and diagnosis of AGHD and then state the effects of growth hormone (GH) therapy
for these patients. The main characteristics of AGHD are abnormal body
composition, dyslipidemia, insulin resistance, and an impaired quality of life
(QoL) due to decreased psychological well-being. For diagnosing AGHD, the
international consensus guidelines have suggested that an insulin tolerance test
(ITT) is the gold standard, but in Japan, the growth hormone releasing peptide-2
(GHRP-2) test is available and is recommended as a convenient and safe GH
stimulating test. The cut-off for diagnosing severe AGHD is a peak GH
concentration of 9 g/L during the GHRP-2 test. Since 2006, GH therapy has been
approved for Japanese patients with severe AGHD. For adults, GH replacement
therapy should be initiated at a low dose (3 g/kg body weight/day), followed by
individualized dose titration while monitoring patients' clinical status and
serum insulin-like growth factor-I (IGF-I) concentrations. A variety of favorable
effects of GH replacement have been indicated; however, it has not yet been
established fully whether there is a direct effect of GH treatment on reducing
mortality.
|Adult
[MESH]
|Age Factors
[MESH]
|Body Composition
[MESH]
|Diagnosis, Differential
[MESH]
|Dyslipidemias/diagnosis/drug therapy
[MESH]
|Human Growth Hormone/*deficiency/therapeutic use
[MESH]