Growth hormone therapy in children and adults

Abstract

Growth hormone is responsible for growth in childhood after the first one to two years, and its deficiency results in short stature. Use of GH has been restricted over the years, initially due to scarcity of supply (human pituitary GH), and thereafter due to expense of the drug (synthetic GH). In the UK, GH is licensed for the treatment of children with GHD, TS, PWS, CRI, and those born SGA who fail to catch up in growth. In some countries GH is used for other indications, and it is also used off-license in the UK for treatment of other conditions (primarily ‘short stature syndromes’). Growth hormone plays an important role in determining peak bone mass in adolescence/early adulthood, and has an important metabolic role in adults. Growth hormone deficiency in adults leads to lack of energy, abnormal body composition (reduced lean mass, increased fat mass), adverse cardiovascular factors (elevated cholesterol and triglycerides, abnormal echocardiography, hypertension), and reduced insulin sensitivity. It is thus associated with reduced quality of life and increased cardiovascular risk.