Current aspects of diagnosis and treatment of adult GH-deficiency

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Abstract


Adult growth hormone (GH) deficiency (AGHD) is a condition characterized by alterations in body composition, lipid and carbohydrate metabolism, bone mineral density and poor quality of life; however, clinical presentations of AGHD are mostly non-specific. Untreated AGHD is associated with increased cardiovascular morbidity and mortality. Stimulation tests are used for the diagnosis: insulin tolerance test, glucagon stimulation test, growth-hormone releasing hormone and arginine stimulation test. Moreover, in 2017 FDA approved the use of macimorelin (oral GH secretagogue) for the diagnosis of AGHD. In childhood GH-deficiency, apolipoprotein A-IV, CFHR4 (complement factor H-related protein 4) and PBP (platelet basic protein) were identified as potential biomarkers of the disease, however, this was not investigated in AGHD. GH treatment starts from the minimal dose, which allows minimizing the adverse effects. According to published meta-analyses, AGHD treatment generally does not lead to increased risk of malignancy and recurrence of sellar neoplasms in adult patients. Published data on GH receptor polymorphism associations with treatment efficacy remains controversial. Development of long-acting GH formulations is a currect perspective for the increase of treatment compliance.


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About the authors

Alexander S. Lutsenko

Endocrinology Research Centre

Author for correspondence.
Email: some91@mail.ru
ORCID iD: 0000-0002-9314-7831
SPIN-code: 4037-1030

Russian Federation, 11, Dm. Ulyanova street, Moscow, 117036

research scientist of neuroendocrinology and bone diseases department

Elena V. Nagaeva

Endocrinology Research Centre

Email: nagaeva_ev@mail.ru
ORCID iD: 0000-0001-6429-7198
SPIN-code: 4878-7810

Russian Federation, 11 Dm.Ulyanova street, Moscow, 117036

MD, PhD

Zhanna E. Belaya

Endocrinology Research Centre

Email: jannabelaya@gmail.com
ORCID iD: 0000-0002-6674-6441
SPIN-code: 4746-7173

Russian Federation, 11 Dm. Ulyanova street, 117036 Moscow

MD, PhD, Professor

Olga S. Chukhacheva

Endocrinology Research Centre

Email: ochukhacheva@gmail.com
ORCID iD: 0000-0001-5675-5419
SPIN-code: 3484-6222

Russian Federation, 11, Dm. Ulyanova street, Moscow, 117036

MD

Tatiana S. Zenkova

Endocrinology Research Centre

Email: tatianazenkova@rambler.ru
ORCID iD: 0000-0002-7724-1617
SPIN-code: 2154-5837

Russian Federation, 11, Dm. Ulyanova street, Moscow, 117036

PhD, MD in neuroendocrinology and bone diseases department

Galina A. Melnichenko

Endocrinology Research Centre

Email: teofrast2000@mail.ru
ORCID iD: 0000-0002-5634-7877
SPIN-code: 8615-0038

Russian Federation, 11 Dm. Ulyanova street, 117036 Moscow

MD, PhD, Professor

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