Growth hormone deficiency pathophysiology
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Growth hormone deficiency Microchapters |
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Differentiating Growth hormone deficiency from other Diseases |
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Diagnosis |
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Treatment |
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Growth hormone deficiency pathophysiology On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pathophysiology
- Though growth ends with sexual maturity, GH continues to be secreted throughout life.
- In adults, GH contributes to maintenance of muscle and bone mass and strength as well as quality and productivity in life. *Understanding of the effects and benefits of GH in adults increased in the 1980's and the features of adult GH deficiency have not only been published, but can be said to have gained some notoriety.
- As an adult ages, diminishing amounts of GH are produced by the pituitary. This is characteristic of other hormones (especially the sex steroids) as well, and most physicians distinguish between the "naturally" reduced (age-related slowing) secretion of aging and the lower levels of real deficiency.
- In adults, the body composition has higher amount of body fat.
GH resistance
There are a variety of rare diseases which resemble GH deficiency, including the childhood growth failure, facial appearance, delayed bone age, and low IGF levels. However, GH testing elicits normal or high levels of GH in the blood, demonstrating that the problem is not due to a deficiency of GH but rather to a reduced sensitivity to its action. GH treatment does not increase IGF levels or improve growth very much.
The traditional term for this condition is Laron dwarfism, but over the last 15 years many different types of GH resistance have been identified, primarily involving mutations of the GH binding protein or receptors. Trials of treatment with IGF1 were not successful enough to warrant adoption as standard use.