The growth hormone activates the processes of growth in all organs and tissues of the organism. If its production is lacking or insufficient, a replacement treatment of the natural hormone based on recombinant GH, a pharmacological molecule completely identical to it, can be administered. This prevents the consequences of untreated deficiency, such as short stature, inadequate muscle and bone development, heart problems.
Deficiency in adulthood
Adults with GH deficiency can be divided into three groups: adults who have GH deficiency from birth or childhood, adults who have developed GH deficiency at a later date, following trauma or other types of damage to the gland that produces the GH itself (pituitary gland), and adults with idiopathic GH deficiency (i.e. without a recognized cause).
It is recommended that adults who have had an early (childhood) onset of GH deficiency and who are receiving recombinant hgh therapy, once they have reached adequate height and adulthood, are re-evaluated for GH deficiency. Unless they have known causes of chronic deficiency such as: genetic mutations, lesions causing multiple hormone deficiencies or irreversible lesions of the producing gland (the pituitary gland).
Recombinant GH therapy has been shown to be beneficial in many GH-deficient adults. It is crucial to identify the individuals in whom treatment is appropriate. Before starting therapy, it is critically important to confirm GH deficiency. Diagnosis is usually based on laboratory evaluations. The benefits of recombinant GH therapy, demonstrated in research and clinical use, include improvements in body composition, ability to exercise, bone and muscle integrity, and quality of life. The risk of increased mortality from cancer hypothesized by some authors has not found confirmation in the studies performed. The dose of the drug must be personalized, also to prevent side effects.
The benefits of recombinant GH treatment
The benefits of recombinant GH treatment in adult patients with GH deficiency relate to various areas: body composition, bone structure and function, cardiovascular risk factors and quality of life.
- One of the most significant effects of recombinant GH treatment is the increase in lipolysis (breaking down of fats). Before treatment, adults suffering from GH deficiency often have increased fat mass and a greater share of visceral fat (deposited in the abdomen) than their healthy peers. Several studies have shown that following treatment with recombinant GH there is a decrease in the percentage of fat mass. Some authors have reported a selective effect of recombinant GH on visceral fat: this effect occurs within six months of starting treatment and is maintained if therapy continues. Obviously, this action on fat deposits is observed only when GH is administered to make up for a deficiency, while it is not observed in subjects who do not have this problem.
- Adults with GH deficiency, compared to healthy peers, also have a reduced lean mass. Usually, an increase in lean body mass occurs in response to recombinant GH treatment, although the degree of change is less than the decrease in fat mass. Again, the change affects only those with GH deficiency.
- Evaluation of some patients with untreated GH deficiency has shown that lack of therapy causes a decrease in the volume of extracellular fluids. In these subjects, the administration of recombinant GH favors a rebalancing.
- In cases of untreated GH deficiency, bone fragility and an increased risk of fractures are observed. Children with GH deficiency who do not receive replacement therapy during puberty and after reaching the expected height have reduced peak bone mass.
- Recombinant GH therapy in adults with GH deficiency improves cardiovascular well-being, for example by improving the state of the endothelium (the inner lining of the blood vessel walls), cholesterol levels, myocardial functions, blood pressure values arterial. However, it tends to increase insulin resistance.
