Although growth hormone has been in clinical use for almost 40 years t
o promote linear growth in children with growth hormone deficiency, re
placement therapy in adults was previously not deemed clinically indic
ated. However, intensive research over the past decade has led to impo
rtant advances in our medical knowledge and improvements in the care f
or patients with growth hormone deficiency. Well-controlled clinical t
rials have demonstrated beneficial effects of replacement therapy with
recombinant human prion-free growth hormone (rhGH; somatropin). The m
ost important restoration parameters include reduction of cardiovascul
ar risk factors and improved lipid profile, normalised body compositio
n, improved exercise capacity and bone mass, as well as enhanced psych
ological well-being. Some important issues regarding growth hormone de
ficiency and long term somatropin treatment are unresolved, such as di
agnostic criteria and the potential for malignancy and impaired glucos
e tolerance. Furthermore, the effect on hard end-points such as life e
xpectancy or vertebral fracture rate is unknown, but is expected to em
erge from physician-managed, multinational databases. Consequently, at
this point somatropin therapy should be given in conjunction with cli
nical trials.