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{{Growth hormone deficiency}} | {{Growth hormone deficiency}} | ||
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==Overview== | ==Overview== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]
Overview
The hallmark of growth hormone deficiency is growth failure. The most common symptoms of GHD in infants are delayed Bone age, perinatal asphyxia, hypoglycemia, and jaundice. Adults symptoms include increased lean body mass, fractures of the lumbar spine, osteopenia.
History and Symptoms
Common symptoms of growth hormone deficiency include:
Neonatal symptoms
- Growth failure can occur during the first months of life but may not be obvious until 6 to 12 months of age.[1]
- Bone age and height age are delayed but at the same age of each other.[2]
- Higher frequency of perinatal asphyxia
- Neonatal morbidity may include hypoglycemia and prolonged jaundice especially if combined with adrenocorticotropic hormone deficiency.
- Cryptorchidism and hypoplasia of the scrotum may occur.
Childhood symptoms
- The single most important clinical manifestation of GHD is growth failure.
- Growth failure may not be obvious until 6-12 months old.
- Children present with doll-like fat distribution pattern, immature face with under developed nasal bridge. The voice is infantile, and hair growth is sparse and thin.
- Developmental milestones may be delayed due to muscle weakness.
Adult symptoms
- Patients with childhood-onset GH deficiency have more severe clinical manifestations than those who develop it as adults.[3]
- Lean body mass is increased in adults who are deficient in GH and not replaced compared with those who have normal GH secretion.[4]
- Fractures of the lumbar spine are higher than normal persons with a high incidence of osteopenia.
- The degree of osteopenia appears to correlate directly with the degree of GH deficiency.[5]
- Less energetic than normal people of the same age[6]
Cardiovascular risk factors
- Dyslipidemia[7]
- Increased inflammatory markers[8]
- Increase in biochemical markers of endothelial dysfunction[9]
- High coronary calcium scores (a marker of subclinical atherosclerosis)[10]
References
- ↑ Wit JM, van Unen H (1992). "Growth of infants with neonatal growth hormone deficiency". Arch Dis Child. 67 (7): 920–4. PMC 1793852. PMID 1519958.
- ↑ Pena-Almazan S, Buchlis J, Miller S, Shine B, MacGillivray M (2001). "Linear growth characteristics of congenitally GH-deficient infants from birth to one year of age". J Clin Endocrinol Metab. 86 (12): 5691–4. doi:10.1210/jcem.86.12.8068. PMID 11739421.
- ↑ Koranyi J, Svensson J, Götherström G, Sunnerhagen KS, Bengtsson B, Johannsson G (2001). "Baseline characteristics and the effects of five years of GH replacement therapy in adults with GH deficiency of childhood or adulthood onset: a comparative, prospective study". J Clin Endocrinol Metab. 86 (10): 4693–9. doi:10.1210/jcem.86.10.7896. PMID 11600527.
- ↑ Cuneo RC, Salomon F, Wiles CM, Sönksen PH (1990). "Skeletal muscle performance in adults with growth hormone deficiency". Horm Res. 33 Suppl 4: 55–60. PMID 2245969.
- ↑ Colao A, Di Somma C, Pivonello R, Loche S, Aimaretti G, Cerbone G; et al. (1999). "Bone loss is correlated to the severity of growth hormone deficiency in adult patients with hypopituitarism". J Clin Endocrinol Metab. 84 (6): 1919–24. doi:10.1210/jcem.84.6.5742. PMID 10372687.
- ↑ McGauley GA (1989). "Quality of life assessment before and after growth hormone treatment in adults with growth hormone deficiency". Acta Paediatr Scand Suppl. 356: 70–2, discussion 73-4. PMID 2816361.
- ↑ Bengtsson BA, Abs R, Bennmarker H, Monson JP, Feldt-Rasmussen U, Hernberg-Stahl E; et al. (1999). "The effects of treatment and the individual responsiveness to growth hormone (GH) replacement therapy in 665 GH-deficient adults. KIMS Study Group and the KIMS International Board". J Clin Endocrinol Metab. 84 (11): 3929–35. doi:10.1210/jcem.84.11.6088. PMID 10566630.
- ↑ Sesmilo G, Miller KK, Hayden D, Klibanski A (2001). "Inflammatory cardiovascular risk markers in women with hypopituitarism". J Clin Endocrinol Metab. 86 (12): 5774–81. doi:10.1210/jcem.86.12.8087. PMID 11739438.
- ↑ Elhadd TA, Abdu TA, Oxtoby J, Kennedy G, McLaren M, Neary R; et al. (2001). "Biochemical and biophysical markers of endothelial dysfunction in adults with hypopituitarism and severe GH deficiency". J Clin Endocrinol Metab. 86 (9): 4223–32. doi:10.1210/jcem.86.9.7813. PMID 11549653.
- ↑ Cannavò S, Marini F, Curtò L, Torre ML, de Gregorio C, Salamone I; et al. (2011). "High prevalence of coronary calcifications and increased risk for coronary heart disease in adults with growth hormone deficiency". J Endocrinol Invest. 34 (1): 32–7. doi:10.3275/7076. PMID 20511726.