Growth hormone deficiency (GHD) and the importance of growth hormone replacement in transition from late adolescence to adulthood: Guidelines for patients with GHD in transition from pediatric to adult endocrinologist

Abstract

Transitional period (TP) is the time of several years in a person's life after reaching of final body height, spanning from about the age of 16 to about the age of 26 years. In this period the person reaches a peak in muscle mass and bone mineral density. Growth hormone deficiency (GHD) in the TP leads to reduced bone mineral density and inadequate body composition with reduced muscle mass and increased abdominal fat mass. GHD in TP is also associated with impaired lipid profile, increased insulin resistance and risk for metabolic syndrome. GH replacement during TP has a favorable effect on bone density and quality, on body composition and on cardiovascular health, thus reducing future morbidity and mortality in adulthood. GH replacement is of particular importance for quality of life improvement in the young patients. To facilitate and optimize the continuance of GH replacement in the TP for the patients treated with GH in childhood, we have comprised these guidelines aimed to improve the communication between pediatric and adult endocrinologists. A closer collaboration between these two services would ensure easier continuance of treatment and follow up for the patients with hypopituitarism in transition to adulthood. The goal of presenting these guidelines is to prevent the drop out of patients with GHD in TP from continuing GH replacement and other relevant hormonal replacement.

Keywords

• growth hormone deficiency
• transitional period
• guidelines