Endocrinology and Metabolism.
Editor(s): Polak M. (Paris), Rogol A.D. (Charlottesville, Pa.), Trainer P. (Manchester)

Adult Workshop 1

New Guidelines for the Diagnosis of Growth Hormone Deficiency in Adults
Felipe F. Casanueva^a, Ana I. Castro^a, Dragan Micic^c, Fahrettin Kelestimur^d, Carlos Dieguez<sup>b

a</sup>Department of Medicine, Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatología Obesidad y Nutrición, Instituto Salud Carlos III, and
^bDepartment of Physiology, School of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain;
^cEndocrinology Department, University Children's Hospital, Belgrade, Serbia;
^dDepartment of Endocrinology, Erciyes University Medical School, Kayseri, Turkey

Address of Corresponding Author

Horm Res 2009;71 (Suppl. 1):112-115 (DOI: 10.1159/000178051)

  Key Words

• Insulin tolerance test
• Growth hormone-releasing hormone (GHRH)-arginine
• Growth hormone releasing hexapeptide
• Glucagon
• Insulin-like growth factor I

  Abstract

Background: The task of diagnosing growth hormone deficiency (GHD) in adults is cumbersome because of the paucity of biological endpoints. Consequently, over the past decade different organizations have attempted to develop homogeneous criteria and methodology for worldwide use. GHD should be biochemically confirmed within an appropriate clinical context - but only if there is the intention to treat. Clinically, patients investigated for GHD should include those with signs and symptoms or a past history of hypothalamo-pituitary dysfunction and those with a history of cranial irradiation, tumour treatment, traumatic brain injury or subarachnoid haemorrhage. Conclusions: Subjects with 3 pituitary hormone deficiencies plus a low insulin-like growth factor I level do not need provocative testing. For those who must be tested, arguably the most commonly used provocative tests are the insulin tolerance test and the glucagon, GH-releasing hormone (GHRH) + arginine and GHRH + GH-releasing hexapeptide tests. Cutoffs differ across tests and results may be influenced by gender, age, body mass index and the assay reference preparation.

Copyright © 2009 S. Karger AG, Basel

  Author Contacts

Felipe F. Casanueva
Endocrine Division, Department of Medicine, University Hospital
Santiago de Compostela University, Calle San Francisco SN, PO Box 563
ES-15780 Santiago de Compostela (Spain)
Tel./Fax +34 981 572 121, E-Mail meffcasa@usc.es

  Article Information

Published online: January 21, 2009
Number of Print Pages : 4
Number of Figures : 2, Number of Tables : 0, Number of References : 21