Natural history of growth hormone receptor deficiency

This review discusses the natural history of growth hormone receptor defici ency (GHRD) in relation to epidemiology, mortality, growth, certain aspects of body composition, and intellectual development. The majority of affecte d individuals are of Semitic origin and 90% come from the Indian peninsula, the Middle East, or elsewhere in the Mediterranean. There is a twofold inc reased mortality before the age of 7 years for children with GHRD. Affected adults may have increased cardiovascular risk resulting from increased tot al cholesterol and low-density lipoprotein cholesterol, unrelated to adipos ity or insulin resistance. Intrauterine growth is affected minimally, if at all. Within a genetically homogeneous population in Ecuador, postnatal gro wth effects are as variable as in a large genetically heterogeneous populat ion. There is no influence of parental heights. Areal bone mineral density is reduced in adults with GHRD, but estimated volumetric bone density (bone mineral apparent density) is normal. Intellectual development is unaffecte d by GHRD.