| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Submitted on October 12, 2005
Accepted on February 22, 2006
Northwestern University Feinberg School of Medicine (M.E.M.), Chicago, Illinois 60611; University of North Carolina School of Medicine (D.R.C.), Chapel Hill, North Carolina 27599; National Institute of Diabetes, Digestive and Kidney Disease (S.M.), National Institutes of Health, Bethesda, Maryland 20892; University of Washington, Veterans Affairs Puget Sound Health Care System (G.R.M.), Seattle and Tacoma, Washington 98493; Christie Hospital (S.M.S.), Manchester M20 4BX, United Kingdom; and University of Virginia Health Science Center (M.L.V.), Charlottesville, Virginia 22908
* To whom correspondence should be addressed. E-mail: molitch{at}northwestern.edu.
Objective: The objective is to provide guidelines for the evaluation and treatment of adults with GH deficiency (GHD).
Participants: The chair of the Task Force was selected by the Clinical Guidelines Subcommittee of The Endocrine Society (TES). The chair selected five other endocrinologists and a medical writer, who were approved by the Council. One closed meeting of the group was held. There was no corporate funding, and members of the group received no remuneration.
Evidence: Only fully published, peer-reviewed literature was reviewed. The Grades of Evidence used are outlined in the Appendix.
Consensus Process: Consensus was achieved through one group meeting and e-mailing of drafts that were written by the group with grammatical/style help from the medical writer. Drafts were reviewed successively by the Clinical Guidelines Subcommittee, the Clinical Affairs Committee, and TES Council, and a version was placed on the TES web site for comments. At each level, the writing group incorporated needed changes.
Conclusions: GHD can persist from childhood or be newly acquired. Confirmation through stimulation testing is usually required unless there is a proven genetic/structural lesion persistent from childhood. GH therapy offers benefits in body composition, exercise capacity, skeletal integrity, and quality of life measures and is most likely to benefit those patients who have more severe GHD. The risks of GH treatment are low. GH dosing regimens should be individualized. The final decision to treat adults with GHD requires thoughtful clinical judgment with a careful evaluation of the benefits and risks specific to the individual.
This article has been cited by other articles:
 |
|
 |
|
  N. Mauras, L. Gonzalez de Pijem, H. Y. Hsiang, P. Desrosiers, R. Rapaport, I. D. Schwartz, K. O. Klein, R. J. Singh, A. Miyamoto, and K. Bishop Anastrozole Increases Predicted Adult Height of Short Adolescent Males Treated with Growth Hormone: A Randomized, Placebo-Controlled, Multicenter Trial for One to Three Years J. Clin. Endocrinol. Metab., March 1, 2008; 93(3): 823 - 831. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. L. Hartman, A. Weltman, A. Zagar, R. L. Qualy, A. R. Hoffman, and G. R. Merriam Growth Hormone Replacement Therapy in Adults with Growth Hormone Deficiency Improves Maximal Oxygen Consumption Independently of Dosing Regimen or Physical Activity J. Clin. Endocrinol. Metab., January 1, 2008; 93(1): 125 - 130. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. di Iorgi, A. Secco, F. Napoli, C. Tinelli, A. Calcagno, N. Fratangeli, L. Ambrosini, A. Rossi, R. Lorini, and M. Maghnie Deterioration of Growth Hormone (GH) Response and Anterior Pituitary Function in Young Adults with Childhood-Onset GH Deficiency and Ectopic Posterior Pituitary: A Two-Year Prospective Follow-Up Study J. Clin. Endocrinol. Metab., October 1, 2007; 92(10): 3875 - 3884. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Brabant GH releasing peptide 2 test: the holy grail of testing GH deficiency? Eur. J. Endocrinol., July 1, 2007; 157(1): 29 - 30. [Full Text] [PDF]
|
|
|
|
|
|
J. Baron Growth Hormone Therapy in Childhood: Titration Versus Weight-Based Dosing? J. Clin. Endocrinol. Metab., July 1, 2007; 92(7): 2436 - 2438. [Full Text] [PDF]
|
|
|
|
|
|
G. Brabant, A. Krogh Rasmussen, B. M. K. Biller, M. Buchfelder, U. Feldt-Rasmussen, K. Forssmann, B. Jonsson, M. Koltowska-Haggstrom, D. Maiter, B. Saller, et al. Clinical Implications of Residual Growth Hormone (GH) Response to Provocative Testing in Adults with Severe GH Deficiency J. Clin. Endocrinol. Metab., July 1, 2007; 92(7): 2604 - 2609. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Manetti, I. Lupi, L. L. Morselli, S. Albertini, M. Cosottini, L. Grasso, M. Genovesi, G. Pinna, S. Mariotti, F. Bogazzi, et al. Prevalence and Functional Significance of Antipituitary Antibodies in Patients with Autoimmune and Non-Autoimmune Thyroid Diseases J. Clin. Endocrinol. Metab., June 1, 2007; 92(6): 2176 - 2181. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. M. C. Pereira, M. H. Aguiar-Oliveira, A. Sagazio, C. R. P. Oliveira, F. T. Oliveira, V. C. Campos, C. T. Farias, T. A. R. Vicente, M. B. Gois Jr, J. L. M. Oliveira, et al. Heterozygosity for a Mutation in the Growth Hormone-Releasing Hormone Receptor Gene Does Not Influence Adult Stature, But Affects Body Composition J. Clin. Endocrinol. Metab., June 1, 2007; 92(6): 2353 - 2357. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Radovick and S. DiVall Approach to the Growth Hormone-Deficient Child during Transition to Adulthood J. Clin. Endocrinol. Metab., April 1, 2007; 92(4): 1195 - 1200. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A A van der Klaauw, J A Romijn, N R Biermasz, J W A Smit, J van Doorn, O M Dekkers, F Roelfsema, and A M Pereira Sustained effects of recombinant GH replacement after 7 years of treatment in adults with GH deficiency. Eur. J. Endocrinol., November 1, 2006; 155(5): 701 - 708. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
| Endocrinology | Endocrine Reviews | J. Clin. End. & Metab. |
| Molecular Endocrinology | Recent Prog. Horm. Res. | All Endocrine Journals |
