Growth hormone deficiency in adults

Adults with Growth hormone (GH) deficiency is now being recognised to display many distinct clinical, metabolic and psychological abnormalities. It has been demonstrated that GI-I deficient (GHD) adults display features of multiple insulin resistant syndrome (MIRS) which predispose the GHD adults to increased cardiovascular morbidity and mortality. These features include central obesity, insulin resistance and glucose intolerance, hypertension, dyslipidaemia that includes a reduced level of high density lipoprotein cholesterol, an elevated triglyceride level and small low density lipoprotein cholesterol size. Furthermore, GHD adults are found to have a lower bone mass and a reduced sense of well-being. Replacement of GH in these GHD adults has brought about a major improvement in psychological well-being and central obesity. The improvement of some of the lipid abnormalities is however more modest. Insulin resistance, the corner stone of MIRS, is however not altered by GH replacement. Long term data is as yet unavailable to assess if GH replacement reduces cardiovascular mortality and morbidity in these subjects