Abstract
GH secretion continues in adulthood and it is well recognized that GH exerts distinct actions also in adults. The advent of biosynthetic GH has prompted renewed interest in the adult GH-deficient (GHD) patient. Our experience with GH replacement in these patients can be summarized as follows:
Short-term effects: On a 24-h basis GH normalizes resting energy expenditure (EE). This is associated with a lowering of protein EE from a supranormal level. Lipid oxidation is increased from a subnormal state. GH also acts to decrease both oxidative glucose disposal and overall insulin sensitivity. Finally, insulin induced hypoglycemia is offset by GH by an increase in peripheral lipid consumption. The overall effects of GH seems to be glucose and protein sparing at the expense of lipids.
Long-term effects: GH therapy normalizes serum IGF-I levels and peripheral thyroid hormone metabolism. Highly significant increments in muscle mass and reductions in fat mass are consistent findings together with increased exercise capacity and muscle strength. GH also restores the decreased extra cellular volume, which may cause transient perturbations in terms of acral swelling and discomfort. Data from other studies indicate improvements in psychological well-being and quality of life. These findings are preserved during more than 3 yrs of treatment.
Conclusions: Adult GHD is associated with distinct abnormaiites most of which become normalized after GH substitution.
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Jøirgensen, J., Skakkebæk, N. & Christiansen, J. GROWTH HORMONE (GH) DEFICIENCY IN ADULTHOOD: SHORT AND LONG TERM EFFECTS OF GH SUBSTITUTION. Pediatr Res 33 (Suppl 5), S9 (1993). https://doi.org/10.1203/00006450-199305001-00037
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DOI: https://doi.org/10.1203/00006450-199305001-00037