Growth hormone replacement in adults with growth hormone deficiency: Assessment of current knowledge

The recent availability of recombinant human growth hormone (GH) has led to intense investigation of the consequences of adult GH deficiency (GHD) and the effects of GH replacement. These studies have led to the identificatio n of a characteristic syndrome of GHD consisting of decreased mood and well -being, with alterations in body composition and substrate metabolism. In b oth placebo-controlled and open studies, GH replacement therapy has consist ently been shown to reverse or correct these features. Whether long-term GH replacement will result in a reduction of osteoporotic fractures, cardiova scular morbidity and mortality is not yet known. To date, no permanent seri ous adverse effects have been associated with GH replacement in GHD, and al though currently expensive, it is anticipated that GH replacement will beco me routine in the treatment of the severely hypopituitary adult.