Metabolic Effects of GH: A Rationale for Continued GH Treatment of GH-Deficient Adults after Cessation of Linear GrowthJuul A. · Jørgensen J.O.L. · Christiansen J.S. · Müller J. · Skakkebœk N.E.
aDepartment of Growth and Reproduction, University of Copenhagen; bDepartment of Internal Medicine (Diabetes and Endocrinology), University of Aarhus, Denmark
GH deficiency in children has been treated for decades with GH in order to normalize growth and final height. After cessation of linear growth GH treatment has traditionally been stopped. However, adults with GH deficiency have increased mortality due to cardiovascular disease and share several clinical signs, such as reduced muscle strength, reduced exercise capacity, reduced sweating ability and thermoregulation, subnormal kidney function, reduced myocardial function, reduced energy expenditure, abnormal thyroid hormone metabolism, impaired psychosocial well-being, decreased lean body mass and decreased bone mineral content. Several studies have shown unanimously that GH replacement therapy in GH-deficient adults have improved all the above-reported clinical symptoms. We conclude that GH deficiency in adults is associated with a number of subnormal features. GH treatment improves (normalizes) these symptoms and we therefore believe that GH replacement therapy of a GH-deficient individual should be continued after cessation of linear growth. However, treatment of such patients should be carefully monitored since data from follow-up studies are still lacking.
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