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    Partial growth hormone deficiency in adults; should we be looking for it?

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    Authors
    Shalet, Stephen M
    Affiliation
    Department of Endocrinology, Christie Hospital NHS Trust, Manchester M20 4BX, UK.
    Issue Date
    2010-04-23
    
    Metadata
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    Abstract
    Summary Quantitatively GH secretion exists as a continuum in states ranging from good health through to hypopituitarism. Currently GH replacement is considered only for adults designated as being severely GH deficient (GHD). In clinical practice the gold standard, on which the biochemical diagnosis of severe GHD is based, centres on the presence of two or more additional anterior pituitary hormone deficits. Cohorts of adults with partial GHD (GHI) have been reported with adverse body composition changes, dyslipidaemia, insulin resistance, altered cardiac performance and increased carotid intima-media thickness. The diagnosis of GHI in an individual patient, however, is extremely difficult because such patients rarely exhibit additional anterior pituitary hormone deficits and the levels of GH-dependent proteins, including IGF-I, are normal in the majority. Currently GH replacement therapy should only be considered in a patient characterised as GHI by dynamic GH testing in whom there is a plausible cause for hypopituitarism and in whom the IGF-I level is pathologically low.
    Citation
    Partial growth hormone deficiency in adults; should we be looking for it? 2010: Clin Endocrinol
    Journal
    Clinical Endocrinology
    URI
    http://hdl.handle.net/10541/109041
    DOI
    10.1111/j.1365-2265.2010.03809.x
    PubMed ID
    20455893
    Type
    Article
    Language
    en
    ISSN
    1365-2265
    ae974a485f413a2113503eed53cd6c53
    10.1111/j.1365-2265.2010.03809.x
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