Consensus guidelines for the diagnosis and treatment of adults with GH deficiency II: a statement of the GH Research Society in association with the European Society for Pediatric Endocrinology, Lawson Wilkins Society, European Society of Endocrinology, Japan Endocrine Society, and Endocrine Society of Australia
Abstract
Objective: The GH Research Society held a Consensus Workshop in Sydney, Australia, 2007 to incorporate the important advances in the management of GH deficiency (GHD) in adults, which have taken place since the inaugural 1997 Consensus Workshop. Method: Two commissioned review papers, previously published Consensus Statements of the Society and key questions were circulated before the Workshop, which comprised a rigorous structure of review with breakout discussion groups. A writing group transcribed the summary group reports for drafting in a plenary forum on the last day. All participants were sent a polished draft for additional comments and gave signed approval to the final revision. Conclusion: Testing for GHD should be extended from hypothalamic–pituitary disease and cranial irradiation to include traumatic brain injury. Testing may indicate isolated GHD; however, idiopathic isolated GHD occurring de novo in the adult is not a recognized entity. The insulin tolerance test, combined administration of GHRH with arginine or growth hormone-releasing peptide, and glucagon are validated GH stimulation tests in the adult. A low IGF-I is a reliable diagnostic indicator of GHD in the presence of hypopituitarism, but a normal IGF-I does not rule out GHD. GH status should be reevaluated in the transition age for continued treatment to complete somatic development. Interaction of GH with other axes may influence thyroid, glucocorticoid, and sex hormone requirements. Response should be assessed clinically by monitoring biochemistry, body composition, and quality of life. There is no evidence that GH replacement increases the risk of tumor recurrence or de novo malignancy.
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GHD has a wide range of test methodology and diagnostic thresholds employed across studies, despite agreement among global guidelines as to what constitutes deficiency.
“GHD in particular has a wide range of test methodology and diagnostic thresholds employed across studies, despite agreement among global guidelines [26 · , 64-67] as to what constitutes deficiency.”
From Neuroendocrine Disruptions Following Head Injury (2023) · cites this paper as [64]
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- Authors
- Ho, K. K. Y., & _, _.
- Affiliations
- Garvan Institute of Medical Research (AU)
- ORCID
- Ho, Ken K Y
- Venue
- European Journal of Endocrinology
- Publisher
- Oxford University Press (OUP)
- Published
- 2007-12
- Volume
- 157
- Issue
- 6
- Pages
- 695-700
- ISSN
- 0804-4643 (ISSN-L)
- 1479-683X
- OpenAlex
- W2130988832
- Cited by
- 615
- References
- 1
- Citations by year
- 2026: 6 · 2025: 18 · 2024: 21 · 2023: 22 · 2022: 34 · 2021: 32 · 2020: 29 · 2019: 23 · 2018: 23 · 2017: 31 · 2016: 40 · 2015: 35 · 2014: 43 · 2013: 40 · 2012: 49
- FWCI
- 28.12
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Keywords
- adult growth hormone deficiency, growth hormone replacement therapy, GH stimulation test, insulin tolerance test, growth hormone-releasing peptide, glucagon stimulation test, insulin-like growth factor I, hypopituitarism, traumatic brain injury, hypothalamic-pituitary disease, cranial irradiation, treatment response monitoring, cancer recurrence risk, de novo malignancy
- MeSH terms
- Adult, Aged, Arginine, Brain Injuries, Female, Glucagon, Humans, Hypopituitarism, Insulin-Like Growth Factor I, Male, Growth Hormone-Releasing Hormone, Human Growth Hormone
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