Page 26 - GALENIKA MEDICAL JOURNAL

normal body composition, reduce the frequency of bone in boys. At that point, the individual has reached 99% of the-
fractures, and improve myocardial function . ir final adult height. It is recommended to then discontinue
32
GH therapy for one to three months and subsequently pro-
We should not overlook the improvement in quality of ceed with retesting . GH doses during transition are closer
31
life during this sensitive psychosocial period of each indivi- to those used in adults with GHD, typically expressed in mi-
dual during therapy, when they become independent and lligrams and not calculated based on body weight. The goal
separate from their parents, whether they continue their is to achieve IGF-I levels within the normal range for age,
education or they get a job. preferably towards the upper limit of normal. The dose for
33
It is considered that 30-70% of individuals with isolated boys during transition is lower compared to that for girls .
idiopathic GHD in childhood, upon retesting during transi- Before starting GH therapy, annual anthropometric me-
tion, have normal GH secretion. The likelihood of GHD per- asurements (body weight, height, hip and waist circumfe-
sisting into adulthood is high in individuals with a history of rence), blood pressure measurement, lipid profile, insulin
sellar region tumors, structural anomalies of the hypotha- sensitivity assessment (fasting glucose, insulin, HbA1c),
lamus/pituitary, or mutations in genes involved in pituitary reproductive function evaluation, thyroid hormone and cor-
embryonic development. On the other hand, individuals tisol levels determination, and assessment of QoL using an
with isolated idiopathic GHD should undergo testing with appropriate questionnaire should be conducted. Baseline
two stimulation tests to confirm or reject the diagnosis of measurement of body composition and bone density by the
GHD. Growth cessation occurs when the growth rate is < 2.0 DXA method is necessary and should be repeated every two
cm per year on adequate GH therapy and when bone matu- to five years during GH therapy .
10
rity corresponds to an age of 14.5 years in girls or 16.5 years

Conclusion

Adult growth hormone deficiency (AGHD) is a syndrome characterized by an unfavorable phenotypic
profile, metabolic disorders, and poor quality of life. Over the last two decades, numerous studies
have confirmed improvements in these parameters with growth hormone (GH) therapy. Although

generally safe, GH replacement requires careful dose titration and monitoring to achieve greater
efficacy and treatment tolerance. Despite the benefits of this treatment, clinical practice suggests
that AGHD is often unrecognized, and GH substitution is underutilized, even though our healthcare
system covers the costs of treatment. The reason lies in physicians' insufficient awareness of the
significance and risks of this therapy, underscoring the need for more intensive education on early
recognition of GHD in adults and treatment optimization.

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24 DOI: 10.5937/Galmed2409023D