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    Defining growth hormone status in adults with hypopituitarism.

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    Authors
    Kaushal, K
    Shalet, Stephen M
    Affiliation
    Department of Endocrinology, Christie Hospital NHS Trust, Manchester, UK.
    Issue Date
    2007
    
    Metadata
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    Abstract
    The identification of adults with severe growth hormone (GH) deficiency (GHD) is not straightforward. The insulin tolerance test remains the gold standard diagnostic test, although other stimuli such as GH-releasing hormone-arginine are gaining acceptance. Insulin-like growth factor-I has a poor diagnostic sensitivity in adult-onset GHD, but is more useful in the subgroup of adults with childhood-onset GHD. Therapeutic developments include increasing recognition of the need to continue GH therapy beyond final height in young adults with severe GHD on retesting. Consensus guidelines have provided a useful algorithm to identify individuals requiring retesting and the number of tests needed. The concept of partial GHD, recognized by paediatric endocrinologists for many years, is being examined in adults with hypothalamic-pituitary disease. Preliminary evidence suggests that this entity is associated with metabolic and anthropometric abnormalities intermediate between those in severe GHD and in healthy controls. It remains to be seen whether this subgroup will derive benefit from GH therapy. To date, therapeutic benefits of GH have been demonstrated only in adults with severe GHD. It is, therefore, imperative that these individuals are unequivocally identified; the diagnosis becomes more uncertain in the presence of obesity, increasing age, and in the absence of additional pituitary hormone deficits.
    Citation
    Defining growth hormone status in adults with hypopituitarism. 2007, 68 (4):185-94 Horm. Res.
    Journal
    Hormone Research
    URI
    http://hdl.handle.net/10541/70154
    DOI
    10.1159/000101286
    PubMed ID
    17389809
    Type
    Article
    Language
    en
    ISSN
    1423-0046
    ae974a485f413a2113503eed53cd6c53
    10.1159/000101286
    Scopus Count
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    All Christie Publications

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