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Growth Hormone Replacement in Adults: The First 10 Years

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Therapeutic Outcome of Endocrine Disorders

Part of the book series: Serono Symposia USA ((SERONOSYMP))

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Abstract

Most physicians until recently considered growth hormone (GH) to have no biological relevance following the cessation of linear growth. The availability of large supplies of recombinant GH throughout the 1990s has prompted intense investigation of the effects of GH in health and disease. Particular emphasis has been paid to the study of adults with GH-deficiency, and our understanding of the consequences of GH-deficiency and the effects of GH replacement in these patients has increased greatly since the publication of the first trials of GH replacement in GH-deficient adults in 1989 (1,2).

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References

  1. Salomon F, Cuneo RD, Hesp R, SÖnksen PH. The effects of treatment with recombinant human growth hormone on body composition and metabolism in adults with growth hormone deficiency. N Eng J Med 1989;321:1797–803.

    Article  CAS  Google Scholar 

  2. Jorgensen JOL, Pedersen SA, Thuesen L, et al. Beneficial effects of growth hormone treatment in GH-deficient adults. Lancet 1989;1:1221–25.

    Article  PubMed  CAS  Google Scholar 

  3. Bengtsson B-A, Eden S, Lonn L, Kvist H, Stokland A, Lindstedt G, et al. Treatment of adults with growth hormone deficiency with recombinant human GH. J Clin Endocri-nolMetab 1993;76:309–17.

    Article  CAS  Google Scholar 

  4. Binnerts A, Swart GR, Wilson JHP, Hoogerbrugge N, Pois HAP, Birkenhager JC, et al. The effect of growth hormone administration in growth hormone deficient adults on bone, protein, carbohydrate and lipid homeostasis, as well as body composition. Clin Endocrinology 1992;37:79–87.

    Article  CAS  Google Scholar 

  5. Chong PKK, Jung RT, Scrimgeour CM, Rennie MJ, Paterson CR. Energy expenditure and body composition in growth hormone deficient adults on exogenous growth hormone. Clin Endocrinology 1994;40:103–10.

    Article  CAS  Google Scholar 

  6. Hoffman DM, O’Sullivan AJ, Freund J, Ho KK. Adults with growth hormone deficiency have abnormal body composition but normal energy metabolism. J Clin Endocrinol Metab 1995;80:72–77.

    Article  PubMed  CAS  Google Scholar 

  7. Beshyah SA, Freemantle C, Thomas E, Rutherford O, Page B, Murphy M, et al. Abnormal body composition and reduced bone mass in growth hormone deficient hypopituitary adults. Clin Endocrinology 1995;42:179–89.

    Article  CAS  Google Scholar 

  8. Rosen T, Bosaeus I, Tolli J, Lindstedt G, Bengtsson BA. Increased body fat mass and decreased extracellular fluid volume in adults with growth hormone deficiency. Clin Endocrinol 1993;38:63–71.

    Article  CAS  Google Scholar 

  9. Amato G, Carella C, Fazio S, La Montagna G, Cittadini A, Sabatini D, et al. Body composition, bone metabolism and heart structure and function in growth hormone-deficient adults before and after GH replacement therapy at low doses. J Clin Endocrinol Metab 1993;77:1671–76.

    Article  PubMed  CAS  Google Scholar 

  10. Snel YE, Doerga ME, Brummer RM, Zelissen PM, Koppeschaar HP. Magnetic resonance imaging-assessed adipose tissue and serum lipid and insulin concentrations in growth hormone-deficient adults. Effect of growth hormone replacement. Arter Thromb Vasc Biol 1995;15:1543–48.

    Article  CAS  Google Scholar 

  11. Moller J, Frandsen E, Fisker S, Jorgensen JOL, Christiansen JS. Decreased plasma and extracellular volume in growth hormone-deficient adults and the acute and prolonged effects of GH administration: a controlled experimental study. Clin Endocrinol 1996;44:533–39.

    Article  CAS  Google Scholar 

  12. Christ E, Cummings MH, Westwood NB, Sawyer BM, Pearson TC, SÖnksen PH, et al. The importance of growth hormone in the regulation of erythropoiesis, red cell mass and plasma volume in adults with growth hormone deficiency. J Clin Endocrinol Metab 1997;82:2985–90.

    Article  PubMed  CAS  Google Scholar 

  13. Jorgensen JOL, Thuesen L, Muller J, et al. Three years of growth hormone treatment in growth hormone-deficient adults: near normalization of body composition and physical performance. Eur J Endocrinol 1994;130:224–28.

    Article  PubMed  CAS  Google Scholar 

  14. Beshyah SA, Freemantle C, Shahi M, Anyaoku V, Merson S, Lynch S, Skinner E, Sharp P, Foale R, Johnston DG. Replacement therapy with biosynthetic human growth hormone in growth hormone-deficient hypopituitary adults. Clin Endocrinol 1995;42:73–81.

    Article  CAS  Google Scholar 

  15. Hoffman DM, Crampton L, Sernia C, Nguyen TV, Ho KKY. Short term growth hormone (GH) treatment of GH-deficient adults increases body sodium and extracellular water, but not blood pressure. J Clin Endocrinol Metab 1996;81:1123–28.

    Article  PubMed  CAS  Google Scholar 

  16. Attanasio AF, Lamberts SWJ, Matranga AMC, Birkett MA, Bates PC, Valk NK, et al. Adult growth hormone-deficient patients demonstrate heterogenity between childhood onset and adult onset before and during human GH treatment. J Clin Endocrinol Metab 1997;82:82–88.

    Article  PubMed  CAS  Google Scholar 

  17. O’Halloran DJ, Tsatsoulis A, Whitehouse RW, Holmes SJ, Adams JE, Shalet SM. Increased bone density after recombinant human growth hormone therapy in adults with isolated GH deficiency. J Clin Endocrinol Metab 1993;76:1344–48.

    Article  PubMed  Google Scholar 

  18. Kaufman JM, Taelman P, Vermeulen A, Van de weghe M. Bone mineral status in growth hormone-deficient males with isolated and multiple pituitary insufficiencies of childhood onset. J Clin Endocrinol Metab 1992;74:118–23.

    Article  PubMed  CAS  Google Scholar 

  19. Holmes SJ, Economou G, Whitehouse RW, Adams JE, Shalet SM. Reduced bone mineral density in patients with adult onset growth hormone deficiency. J Clin Endocrinol Metab 1994;78:669–74.

    Article  PubMed  CAS  Google Scholar 

  20. Degerblad M, Bengtsson BA, Bramnert M, Johnell O, Manhem P, Rosen T, et al. Reduced bone mineral density in adults with growth hormone deficiency: increased bone turnover during 12 months of GH substitution. Eur J Endocrinol 1995;133:180–88.

    Article  PubMed  CAS  Google Scholar 

  21. Wüster CHR, Slenczka E, Ziegler R. Increased prevalence of osteoporosis and arteriosclerosis in patients with conventionally substituted pituitary insufficiency: Is there a need for additional growth hormone substitution? Klin Wochenschrift 1991;69:769–73.

    Article  Google Scholar 

  22. Beshyah SA, Kyd P, Thomas E, Fairney A, Johnston DG. The effects of prolonged growth hormone replacement on bone metabolism and bone mineral density in hypopituitary adults. Clin Endocrinol 1995;42:249–54.

    Article  CAS  Google Scholar 

  23. Vandeweghe M, Taelman P, Kaufman JM. Short and long-term effects of growth hormone treatment on bone turnover and bone mineral content in adult growth hormone-deficient males. Clin Endocrinol 1993;39:409–15.

    Article  Google Scholar 

  24. Cuneo RC, Salomon F, Wiles CM, et al. Growth hormone treatment in growth hormone-deficient adults. II. effects on exercise performance. J Appl Physiol 1991;70:695–700.

    PubMed  CAS  Google Scholar 

  25. Cuneo RC, Salomon F, Wiles CM, et al. Skeletal muscle performance in adults with growth hormone deficiency. Horm Res 1990;33(suppl 4):55–60.

    Article  PubMed  Google Scholar 

  26. Cuneo RC, Salomon F, Wiles CM, et al. Growth hormone treatment in growth hormone-deficient adults. I. Effects on muscle mass and strength. J Appl Physiol 1991;70:688–94.

    PubMed  CAS  Google Scholar 

  27. Degerblad M, Almkvist O, Grunditz R, et al. Physical and psychological capabilities during substitution therapy with recombinant growth hormone in adults with growth hormone deficiency. Acta Endocrinologica 1990;23:185–93.

    Google Scholar 

  28. Rosen T, Bengtsson B-A. Premature mortality due to cardiovascular disease in hypopituitarism. Lancet 1990;336:285–88.

    Article  PubMed  CAS  Google Scholar 

  29. Markussis V, Beshyah SA, Fisher C, Sharp P, Nicolaides AN, Johnston DG. Detection of premature atherosclerosis by high-resolution ultrasonography in symptom-free hypopituitary adults. Lancet 1992;340:1:188–92.

    Google Scholar 

  30. Lehmann ED, Hopkins KD, Weissberger AJ, Gosling RG, SĂ–nksen PH. Aortic distensibility in growth hormone deficient adults. Lancet 1993;341:309.

    Article  PubMed  CAS  Google Scholar 

  31. Cuocolo A, Nicolai E, Colao A, Longobardi S, Cardei S, Fazio S, et al. Improved left ventricular function after growth hormone replacement in patients with hypopituitar-ism: assessment with radionuclide angiography. Eur J Nucl Med 1996;23:390–94.

    Article  PubMed  CAS  Google Scholar 

  32. Caidahl K, Edén S, Bengtsson B-Å. Cardiovascular and renal effects of growth hormone. Clin Endocrinol 1994;40:393–400.

    Article  CAS  Google Scholar 

  33. Thuesen L, Jorgensen JOL, Muller JR, et al. Short and long-term cardiovascular effect of growth hormone therapy in growth hormone deficient adults. Clin Endocrinol 1994;41:615–20.

    Article  CAS  Google Scholar 

  34. Jorgensen JOL, Pedersen SA, Laurberg P, et al. Effects of growth hormone therapy on thyroid function of growth hormone-deficient adults with and without concomitant thyroxine-substituted central hypothyroidism. J Clin Endocrinol Metab 1989;69:1127–32.

    Article  PubMed  CAS  Google Scholar 

  35. Hussain MA, Schmitz O, Mengel A, Glatz Y, Christiansen JS, Zapf J, et al. Comparison of the effects of growth hormone and insulin-like growth factor I on substrate oxidation and on insulin sensitivity in growth hormone-deficient humans. J Clin Invest 1994;94:1126–33.

    Article  PubMed  CAS  Google Scholar 

  36. Russell-Jones DL, Weissberger AJ, Bowes SB, et al. The effects of growth hormone on protein metabolism in adult growth hormone deficient patients. Clin Endocrinol 1993;38:427–31.

    Article  CAS  Google Scholar 

  37. O’Neal DN, Kalfas A, Dunning PL, et al. The effect of 3 months of recombinant human growth hormone (GH) therapy on insulin and glucose-mediated glucose disposal and insulin secretion in GH-deficient adults: a minimal model analysis. J Clin Endocrinol Metab 1994;79:975–83.

    Article  PubMed  Google Scholar 

  38. Hew FL, Koschmann M, Christopher M, Rantzau C, Vaag A, Ward G, et al. Insulin resistance in growth hormone-deficient adults: defects in glucose utilization and glycogen synthase activity. J Clin Endocrinol Metab 1996;81:555–64.

    Article  PubMed  CAS  Google Scholar 

  39. Fowelin J, Attvall S, Lager I, Bengtsson BA. Effects of treatment with recombinant human growth hormone on insulin sensitivity and glucose metabolism in adults with growth hormone deficiency. Metab Clin Exp 1993;42:1443–47.

    Article  PubMed  CAS  Google Scholar 

  40. De Boer H, Blok GJ, Voerman HJ, Phillips M, Schouten JA. Serum lipid levels in growth hormone-deficient men. Metab Clin Exp 1994;43:199–203.

    Article  PubMed  Google Scholar 

  41. Cuneo RC, Salomon F, Watts GF, Hesp R, SÖnksen PH. Growth hormone treatment improves serum lipids and lipoproteins in adults with growth hormone deficiency. Metab Clin Exp 1993; 42: 1519–23.

    Article  PubMed  CAS  Google Scholar 

  42. Rosen T, Eden S, Larson G, Wilhelmsen L, Bengtsson B-Å. Cardiovascular risk factors in adult patients with growth hormone deficiency. Acta Endocrinologica 1993; 129: 195–200.

    PubMed  CAS  Google Scholar 

  43. Russell-Jones DL, Watts GF, Weissberger A, Naumova R, Myers J, Thompson GR, et al. The effect of growth hormone replacement on serum lipids, lipoproteins, apolipoproteins and cholesterol precursors in adult growth hormone deficient patients. Clin Endocrinol 1994; 41: 345–50.

    Article  CAS  Google Scholar 

  44. Johansson G, Oscarsson J, Rosen T, Wiklund O, Olsson G, Wilhelmsen L, et al. Effects of 1 year of growth hormone therapy on serum lipoprotein levels in growth hormone-deficient adults. Influence of gender and Apo(a) and Apo(E) phenotypes. Arter Thromb Vase Biol 1995; 15: 2142–50.

    Article  Google Scholar 

  45. Garry P, Collins P, Devlin JG. An open 36 month study of lipid changes with growth hormone in adults: lipid changes following replacement of growth hormone in adult acquired growth hormone deficiency. Eur J Endocrinol 1996; 134: 61–66.

    Article  PubMed  CAS  Google Scholar 

  46. Eden S, Wiklund O, Oscarsson J, Rosen T, Bengtsson B-A. Growth hormone treatment of growth hormone-deficient adults results in a marked increase in Lp(a) and HDL cholesterol concentrations. Arter Thromb 1993; 13: 296–301.

    Article  CAS  Google Scholar 

  47. Angelin B, Rudling M. Growth hormone and hepatic lipoprotein metabolism. Curr OpinLipidol 1994; 5: 160–65.

    Article  CAS  Google Scholar 

  48. Stabler B, Turner JR, Girdler SS, Light KC, Underwood LE. Reactivity to stress and psychological adjustment in adults with pituitary insufficiency. Clin Endocrinol 1992; 6: 467–73.

    Article  Google Scholar 

  49. Rosen T, Wiren L, Wilhelmsen L, Wiklund I, Bengtsson BA. Decreased psychological well-being in adult patients with growth hormone deficiency. Clin Endocrinol 1994; 40: 111–16.

    Article  CAS  Google Scholar 

  50. McGauley GA. Quality of life assessment before and after growth hormone treatment in adults with growth hormone deficiency. Acta Paediatr Scand 1989; 356(suppl): 55–59.

    Google Scholar 

  51. Burman P, Broman JE, Hetta J, Wiklund I, Erfurth EM, Hagg E, et al. Quality of life in adults with growth hormone (GH) deficiency: response to treatment with recombinant human GH in a placebo-controlled 21-month trial. J Clin Endocrinol Metab 1995; 80: 3585–90.

    Article  PubMed  CAS  Google Scholar 

  52. Carroll PV, Littlewood R, Weissberger AJ, Bogalho P, McGauley G, SÖnksen PH, Russell-Jones DL. The effects of two doses of replacement growth hormone on the biochemical, body composition and psychological profiles of growth hormone-deficient adults. Eur J Endocrinol 1997; 137: 146–53.

    Article  PubMed  CAS  Google Scholar 

  53. Johansson JO, Larson G, Andersson M, Elmgren A, Hynsjo L, Lindahl A, et al. Treatment of growth hormone-deficient adults with recombinant human growth hormone increases the concentration of growth hormone in the cerebrospinal fluid and affects neurotransmitters. Neuroendocrinology 1995; 61: 57–66.

    Article  PubMed  CAS  Google Scholar 

  54. Holmes SJ, Shalet SM. Which adults develop side-effects of growth hormone replacement? Clin Endocrinol 1995; 43: 143–9.

    Article  CAS  Google Scholar 

  55. Mårdh G, Lundin K, Borg G, Jonsson B, Lindeberg A. Growth hormone replacement therapy in adult hypopituitary patients with growth hormone deficiency: combined data from 12 European placebo-controlled trials. Endocrinol Metab 1994; 1(supplA): 43–49.

    Google Scholar 

  56. Malozowski S, Tanner LA, Wysowski D, Fleming GA. Growth hormone, insulin-like growth factor-I, and benign intracranial hypertension. N Engl J Med 1993; 329: 665–66.

    Article  PubMed  CAS  Google Scholar 

  57. Taback SP, Dean HJ. Mortality in Canadian children with growth hormone (GH) deficiency receiving GH therapy 1967-1992. The Canadian Growth Hormone Advisory Commitee. J Clin Endocrinol Metab 1996; 81: 1693–96.

    Article  PubMed  CAS  Google Scholar 

  58. Moshang T Jr., Rundle AC, Graves DA, Nickas J, Johanson A, Meadows A. Brain tumor recurrence in children treated with growth hormone: the National Cooperative Growth Study experience. J Pediatr 1996; 128: 84–7.

    Google Scholar 

  59. Rudman D, Kutner MH, Rogers CM, et al. Impaired growth hormone secretion in the adult population: relation to age and adiposity. J Clin Invest 1981; 67: 1361–69.

    Article  PubMed  CAS  Google Scholar 

  60. Consensus guidelines for the diagnosis and treatment of adults with growth hormone deficiency: summary statement of the Growth Hormone Research Society Workshop on adult growth hormone deficiency. J Clin Endocrinol Metab 1998; 83: 379–81.

    Google Scholar 

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© 2000 Springer Science+Business Media New York

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Carroll, P.V., Christ, E.R., Sönksen, P.H. (2000). Growth Hormone Replacement in Adults: The First 10 Years. In: Stabler, B., Bercu, B.B. (eds) Therapeutic Outcome of Endocrine Disorders. Serono Symposia USA. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-1230-0_2

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  • DOI: https://doi.org/10.1007/978-1-4612-1230-0_2

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