An overview of the controversies of adult growth hormone deficiency diagnosis.

IF 2.7 Q3 ENDOCRINOLOGY & METABOLISM
Daniela Cuboni, Luigi Simone Aversa, Silvia Grottoli, Ezio Ghigo, Valentina Gasco
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引用次数: 0

Abstract

Introduction: Growth hormone (GH) not only drives growth but also has significant metabolic, structural, and quality-of-life impacts. While GH deficiency (GHD) in childhood impairs growth, in adulthood, it leads to metabolic syndrome and multisystem functional abnormalities, collectively termed adult GHD syndrome. Despite being recognized for decades, adult GHD syndrome continues to pose diagnostic and therapeutic challenge.

Areas covered: The aim of this review is to analyze the main controversies that persist in diagnosing adult GHD more than 30 years after the initial studies demonstrating the existence of GHD syndrome in adulthood.

Expert opinion: The only reliable method for diagnosing adult GHD is demonstrating the failure of GH levels to rise above a specific threshold following pharmacological stimulation tests. Various tests are available, and the choice of the most appropriate one depends on the clinical context, the presence of potential contraindications, and the availability of specific pharmacological agents. It is also important to note that the reproducibility of some stimulation tests for diagnosing adult GHD has been questioned. The GH cutoff values considered diagnostic for GHD differ depending on the test used, are significantly influenced by the individual's body composition and age as well as by assay method employed.

成人生长激素缺乏症诊断争议综述。
生长激素(GH)不仅促进生长,而且对代谢、结构和生活质量也有重要影响。虽然生长激素缺乏症(GHD)在儿童时期损害生长,但在成年期,它会导致代谢综合征和多系统功能异常,统称为成人GHD综合征。成人GHD综合征尽管已被认识了几十年,但仍对诊断和治疗构成挑战。涵盖领域:本综述的目的是分析在初步研究表明成人GHD综合征存在30多年后,诊断成人GHD的主要争议。专家意见:诊断成人GHD的唯一可靠方法是在药理学刺激试验后证明生长激素水平未能上升到特定阈值以上。有各种各样的测试可供选择,而选择最合适的测试取决于临床情况、潜在禁忌症的存在以及特定药理学药物的可用性。同样值得注意的是,一些用于诊断成人GHD的刺激试验的可重复性受到质疑。生长激素临界值被认为是GHD的诊断依据所使用的测试而不同,受个体的身体组成和年龄以及所采用的测定方法的显著影响。
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来源期刊
Expert Review of Endocrinology & Metabolism
Expert Review of Endocrinology & Metabolism ENDOCRINOLOGY & METABOLISM-
CiteScore
4.80
自引率
0.00%
发文量
44
期刊介绍: Implicated in a plethora of regulatory dysfunctions involving growth and development, metabolism, electrolyte balances and reproduction, endocrine disruption is one of the highest priority research topics in the world. As a result, we are now in a position to better detect, characterize and overcome the damage mediated by adverse interaction with the endocrine system. Expert Review of Endocrinology and Metabolism (ISSN 1744-6651), provides extensive coverage of state-of-the-art research and clinical advancements in the field of endocrine control and metabolism, with a focus on screening, prevention, diagnostics, existing and novel therapeutics, as well as related molecular genetics, pathophysiology and epidemiology.
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