Adult Growth Hormone Deficiency and Replacement Therapy: Current Approaches

Background: Adult Growth Hormone (GH) deficiency is a significant clinical condition affecting 2-3 per 10,000 individuals, characterized by metabolic, cardiovascular, and quality of life impairments. Objective: To provide a comprehensive review of adult GH deficiency epidemiology, diagnosis, and replacement therapy approaches. Methods: Review of current literature on adult GH deficiency, including epidemiology, clinical manifestations, diagnostic methods, and treatment protocols. Results: Adult GH deficiency presents with central obesity, decreased muscle mass, cardiovascular risk factors, reduced bone density, and impaired quality of life. Pituitary adenomas (57%) and craniopharyngiomas are the leading causes. The insulin tolerance test remains the gold standard for diagnosis, with peak GH <3 µg/L indicating severe deficiency. Re-evaluation is critical for childhood GH deficiency patients, as 30% - 70% may normalize in adulthood. GH replacement therapy, initiated at 0.2 mg/day and titrated based on IGF-1 levels, significantly improves body composition, cardiovascular risk profile, and quality of life. Treatment is generally safe with manageable side effects, including arthralgia and fluid retention. Conclusion: Adult GH deficiency requires individualized diagnosis and treatment approaches. GH replacement therapy is safe and effective when properly monitored, with no increased malignancy risk. Transition period management from pediatric to adult care is crucial for optimal outcomes.