Growth Hormone Deficiency in Adults

  • Author: Mohsen S Eledrisi, MD, FACP, FACE; Chief Editor: George T Griffing, MD  more...
 
Updated: Sep 23, 2015
 

Background

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.

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Pathophysiology

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.[1]

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.

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Epidemiology

An estimated 6,000 adults are diagnosed with GH deficiency every year in the United States.[2] 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.[3]

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.

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Prognosis

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.

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Patient Education

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 DeficiencyGrowth Hormone Deficiency in ChildrenGrowth Failure in ChildrenGrowth Hormone Deficiency Medications, and Growth Hormone Deficiency FAQs.

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Contributor Information and Disclosures
Author

Mohsen S Eledrisi, MD, FACP, FACE Senior Consultant, Department of Medicine/Endocrinology, Hamad Medical Corporation, Qatar

Mohsen S Eledrisi, MD, FACP, FACE is a member of the following medical societies: American Association of Clinical Endocrinologists, Endocrine Society, American College of Physicians-American Society of Internal Medicine, American Diabetes Association, American Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Don S Schalch, MD Professor Emeritus, Department of Internal Medicine, Division of Endocrinology, University of Wisconsin Hospitals and Clinics

Don S Schalch, MD is a member of the following medical societies: American Diabetes Association, American Federation for Medical Research, Central Society for Clinical and Translational Research, Endocrine Society

Disclosure: Nothing to disclose.

Chief Editor

George T Griffing, MD Professor Emeritus of Medicine, St Louis University School of Medicine

George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, International Society for Clinical Densitometry, Southern Society for Clinical Investigation, American College of Medical Practice Executives, American Association for Physician Leadership, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical and Translational Research, Endocrine Society

Disclosure: Nothing to disclose.

Additional Contributors

Steven R Gambert, MD Professor of Medicine, Johns Hopkins University School of Medicine; Director of Geriatric Medicine, University of Maryland Medical Center and R Adams Cowley Shock Trauma Center

Steven R Gambert, MD is a member of the following medical societies: Alpha Omega Alpha, American Association for Physician Leadership, American College of Physicians, American Geriatrics Society, Endocrine Society, Gerontological Society of America, Association of Professors of Medicine

Disclosure: Nothing to disclose.

Acknowledgements

Ali A Al-Qarni, MD, Consulting Endocrinologist, King Abdulaziz National Guard Hospital, Saudi Arabia, contributed to previous versions of this article.

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