GROWTH HORMONE DEFICIENCY IN ADULTS: ETIOLOGY, EFFECTS ON BONE STRUCTURE AND METABOLISM

Authors

  • Abdullaeva Aziza Uktam qizi
  • Khalimova Zamira Yusupovna
  • Kholova Dilorom Sharifovna
  • Uralova Dilafruz Ulugbek qizi

Keywords:

Growth hormone, Adult-onset growth hormone deficiency (AО – GHD), insulin-like growth factor – 1, DXA

Abstract

Adult-onset growth hormone deficiency (GHD) remains one of the issues in clinical endocrinology. In this article, which is addressed to practitioners, physiology of growth hormone in adults is reviewed along with etiology and diagnostic criteria of this medical condition. In general, a stimulation test is required to recognize GHD. Insulin tolerance test (ITT) has been considered the gold standard by the most important scientific societies, although alternative tests, in particular GHRH plus arginine have been proposed as valuable alternative to ITT. This hormone plays a key role in regulating growth, bone formation, and overall metabolism. However, although growth hormone deficiency is often associated with childhood development, it can also occur in adults. This is a serious medical problem. Current GHD classification distinguishes patients with childhood – onset growth hormone deficiency (CO – AGHD) and adult – onset growth hormone deficiency (AO – AGHD), with an incidence of 2 in 100,000 or 1 in 10,000 per year, respectively.

References

Andrzej Lewiński12, Joanna Smyczyńska2, Renata Stawerska2, Maciej Hilczer3, Magdalena Stasiak2, Tomasz Bednarczuk4, Marek Bolanowski5, Roman Junik6, Marek Ruchała7, Anhelli Syrenicz8, Mieczysław Walczak9, Wojciech Zgliczyński10, Małgorzata Karbownik-Lewińska211. DOI: 10.5603/EP.a2018.0054 (https://doi.org/10.5603/EP.a2018.0054).

Arnika Wydra, Izabekka Czasjka – Oraniec, Jakub Wydra, Wojciech Zgliczynski The influence of growth hormone deficiency on bone health and metabolism et al. J Reumatologia2023;61, 4 : p: 239 – 247.

Ashraf Mohamed Assistant prof. of Internal Medicine, Faculty of Medicine, Mansoura University, Egypt Correspondence to Ashraf Mohamed, MD, Assistant prof. of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Dakahlyiah, Serum β-CrossLaps as a predictor for osteoporosis in postmenopausal women with early diabetic nephropathy The Egyptian Journal of Internal Medicine 2019, 31:52–5

Asolkar S.V., Sivaprasad N., Deshpande A., Shah K.B., Mani R.S. Ra-dioimmunoassay of human growth hormone and its application in pitu-itary dysfunction studies. J. Radioanal. Chem. 1981; 65(1–2): 297–305.Fleseriu M, Hashim IA, Karavitaki N, et al. J Clin Endocrinol Metab. 2018. DOI: 10.1210/jc.2016-2118.

Bartke A. Somatic growth, aging, and longevity. NPJ Aging Mech Dis. 2017; 29: 3-14.Bengtsson B.-A., Edin S., Lonn L. et al //J. clin. Endocr. 1993,Vol. 76, P. 309-317. https://doi.org/10.14341/probl12151.

Evaluation and treatment of Adult Growth Hormone Deficiency: An Endocrine Society Clinical Practice Guideline // The Journal of Clinical Endocrinology & Metabolism. – V. 91. – Р. 1621–1634

Evaluation and treatment of Adult Growth Hormone Deficiency: An Endocrine Society Clinical Practice Guideline // The Journal of Clinical Endocrinology & Metabolism. – V. 91. – Р. 1621–1634

Fleseriu M, Hashim IA, Karavitaki N, et al. J Clin Endocrinol Metab. Nov.; 101(11):3888-3921. doi: 10.1210/jc.2016-2118. Epub 2016

Hazem, A., Elamin, M. B., Bancos, I., Malaga, G., Prutsky, G., Domecq, J. P., et al. (2012). Body composition and quality of life in adults treated with GH therapy: a systematic review and meta-analysis. Eur. J. Endocrinol. 166, 13–20. doi:10.1530.EJE-11-0558

Kassem M, Blum W, Ristelli J, Mosekilde L, Eriksen EF 1993 Growth hormone stimulates proliferation and differentiation of normal human osteoblast-like cells in vitro. Calcif Tissue Int 52:222–226.

Mazziotti G, Lania AG, Canalis E. Skeletal disorders associated with the growth hormone-insulin-like growth factor 1axis. Nat Rev Endocrinol 2022; 18: 353–365, DOI: 10.1038/ s41574-022-00649-8.

Melmed S. Idiopathic adult growth hormone deficiency. J Clin Endocrinol Metab 2013; 98:2187 – 97. Bengtsson B.-A., Edin S., Lonn L. et al //J. clin. Endocr. 1993,Vol. 76, P. 309-317. https://doi.org/10.14341/probl12151

Melmed S. Idiopathic adult growth hormone deficiency. J Clin Endocrinol Metab 2013; 98:2187 – 97.

Molitch ME, Clemmons DR, Malozowski S, et al. Endocrine Society. Evaluation and treatment of adult growth hormone deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011; 96: 1587–1609, DOI: 10.1210/ jc.2011-0179.

Powrie J., Weissberger A., Sonksen P. Growth hormone replacement therapy for growth hormone-deficient adults // Drugs. – 1995. – № 49. – Р. 656–663

Tritos NA, Hamrahian AH, King D, Greenspan SL, Cook DM, Jonsson PJ, Wajnrajch MP, Koltowska-Haggstrom M, Biller BM. A longer interval without GH replacement and female gender are associated with lower bone mineral density in adults with childhood-onset GH deficiency: a KIMS database analysis. European Journal of Endocrinology 2012.167 343–351.

Tritos NA, Klibanski A. Effects of Growth Hormone on Bone. Prog Mol Biol Transl Sci 2016; 138: 193–211, DOI:10.1016/bs.pmbts.2015.10.008.

Vaks V.V., Gerasimenko O.A., Dzeranova L.K. Приобретённая недостаточность гормона роста у взрослых: этиология, клинические проявления, диагностика и возможности лечения. Ожирение и метаболизм. 2011;8(2):11-17. https://doi.org/10.14341/2071-8713-4947

Ван ден Белд А.В., Кауфман Дж.М., Цилликенс М.К., Ламбертс С.Дж., Иган Дж.М., ван дер Лели А.Дж. Физиология эндокринной системы с возрастом. Lancet Diabetes Endocrinol (2018) 6: 647-58. 10.1016/S2213-8587(18)30026-3 [Бесплатная статья PMC] [PubMed] [Перекрестная ссылка] [Google Scholar]

Диагностика и лечение приобретенной недостаточности гормона роста у взрослых / И.И.Дедов, В.В. Вакс, Е.И. Марова. – М., 2001.2.

Published

2024-11-06