Growth Hormone Deficiency in Adults
- Author: Mohsen S Eledrisi, MD, FACP, FACE; Chief Editor: George T Griffing, MD more...
The somatotroph cells of the anterior pituitary gland produce growth hormone (GH), which is stimulated by GH-releasing hormone (GHRH) and inhibited by somatostatin, both of which are produced by the hypothalamus.
GH deficiency in adults usually manifests as reduced physical performance and impaired psychological well being.
The goals of GH therapy in adults are to improve conditioning and strength, improve quality of life, and decrease the burden of associated medical conditions such as cardiovascular disease and reduced bone mineral density.
GH deficiency results in alterations in the physiology of different systems of the body, manifesting as altered lipid metabolism, increased subcutaneous visceral fat, decreased muscle mass, decreased bone density, low exercise performance, and reduced quality of life.
Adult GH deficiency can be a transition from childhood-onset GH deficiency or can be acquired during adulthood. The majority of cases are caused by pituitary tumors or by their treatment with surgery, radiation therapy, or both.
An estimated 6,000 adults are diagnosed with GH deficiency every year in the United States. Adult GH deficiency has been estimated to affect 1 in 100,000 people annually, while its incidence rate is approximately 2 cases per 100,000 population when childhood-onset GH deficiency patients are considered. About 15-20 % of the cases represent the transition of childhood GH deficiency into adulthood.
The age of presentation of acquired GH deficiency in adults often coincides with the discovery of pituitary tumors, usually between the fourth and fifth decades of life.
Prognosis is determined by the underlying cause of GH deficiency and the response to GH replacement therapy. Most patients report improvement in quality of life with GH replacement therapy.
Patients should be educated about the technique of subcutaneous injection of GH.
For excellent patient education resources, visit eMedicineHealth's Thyroid and Metabolism Center. Also, see eMedicineHealth's patient education articles Growth Hormone Deficiency, Growth Hormone Deficiency in Children, Growth Failure in Children, Growth Hormone Deficiency Medications, and Growth Hormone Deficiency FAQs.
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