Aversa Luigi Simone, Cuboni Daniela, Grottoli Silvia, Ghigo Ezio, Gasco Valentina
Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, 10126 Turin, Italy.
J Clin Med. 2024 Oct 12;13(20):6079. doi: 10.3390/jcm13206079.
Adult growth hormone deficiency (GHD) has been recognized since the late 1980s. The clinical manifestations of adult GHD are often nonspecific, and diagnosis relies on GH stimulation tests, which are intricate, costly, time-consuming, and may carry the risk of adverse effects. Diagnosis is further complicated by factors like age, sex, and BMI, which affect GH response during testing. Therefore, GH replacement therapy remains challenging, requiring careful individualized evaluation of risks and benefits. The aim of this review is to provide an update on diagnosing and treating adult GHD, addressing current limitations and challenges based on recent studies. We conducted a comprehensive review of the literature regarding the diagnosis and management of adult GHD by searching PubMed and EMBASE. Only articles in English were included, and searches were conducted up to August 2024. A review of guidelines and literature up to 2024 highlights the significant heterogeneity in the data and reveals various protocols for managing GHD, covering both diagnostic and therapeutic approaches. Despite diagnostic and treatment advances, managing adult GHD remains challenging due to variable presentation and the need for personalized GH therapy. Future efforts should aim to improve and standardize diagnostic and treatment protocols.
成人生长激素缺乏症（GHD）自20世纪80年代末以来已被认识。成人GHD的临床表现往往不具有特异性，诊断依赖于生长激素刺激试验，这些试验复杂、昂贵、耗时，且可能有不良反应风险。年龄、性别和体重指数等因素会影响检测期间的生长激素反应，使诊断进一步复杂化。因此，生长激素替代疗法仍然具有挑战性，需要对风险和益处进行仔细的个体化评估。本综述的目的是提供成人GHD诊断和治疗的最新情况，基于近期研究探讨当前的局限性和挑战。我们通过检索PubMed和EMBASE对有关成人GHD诊断和管理的文献进行了全面综述。仅纳入英文文章，检索截至2024年8月。对截至2024年的指南和文献的综述突出了数据中的显著异质性，并揭示了各种管理GHD的方案，涵盖诊断和治疗方法。尽管在诊断和治疗方面取得了进展，但由于表现各异且需要个性化生长激素治疗，管理成人GHD仍然具有挑战性。未来的努力应旨在改进和规范诊断和治疗方案。
