SYNDROME OF GROWTH HORMONE DEFICIENCY IN ADULTS – EFFECTS OF GROWTH HORMONE REPLACEMENT THERAPY

Background. After the cessation of longitudinal growth, growth hormone (GH) continues to subserve an important role in the regulation of body metabolism (stimulation of lipolysis and lipid oxidation, protein synthesis, insulin antagonism, and sodium and water retention) to optimise body composition and function. Most patients with hypopituitarism exhibit the syndrome of GH deficiency with a number of abnormal features which can be reversed with recombinant GH replacement therapy.Conclusions. GH-deficient patients have decreased lean body mass and bone mineral content, increased fat mass, reduced muscle strength and exercise performance, dyslipidemia and increased prevalence of other risk factors for atherosclerosis. They exhibit increased cardiovascular morbidity and mortality and impaired quality of life. It has been shown that GH replacement normalises body composition and exercise capacity, reverses early atherosclerotic changes in major arteries, improves cognitive functions and quality of life. As the treatment with recombinant GH is life-long and expensive it should be offered to patients who exhibit most symptoms and have been proven to have severe GH-deficiency.