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En los últimos años, el tratamiento sustitutivo con hormona del crecimiento (GH) para adultos deficitarios ha pasado de representar una perspectiva a ser una indicación clínica, y ha quedado suficientemente demostrada su efectividad al revertir la mayor parte de las manifestaciones del síndrome de deficiencia de GH en el adulto. La experiencia ha permitido diferenciar entre adultos que habían presentado la deficiencia antes de finalizar el crecimiento y la pubertad y los que la presentaban posteriormente. Las diferencias no son sólo etiológicas, sino que también lo son sus características fenotípicas y la respuesta al tratamiento. En este artículo se revisan las distintas formas de presentación según el momento de instauración y los efectos sobre la composición corporal, la densidad mineral ósea, la calidad de vida relacionada con la salud y el perfil lipídico, que comporta la supresión de la GH cuando se alcanza la talla final. También se evalúan los resultados de la reintroducción del tratamiento con GH tras un período libre de tratamiento en adultos a los que se les suprime la GH al llegar a la talla final.
Palabras clave:
Déficit de hormona del crecimiento en el adulto
Hipopituitarismo
Hormona del crecimiento
Tratamiento
Composición corporal
Calidad de vida relacionada con la salud
In the last few years, growth hormone (GH) replacement therapy in GHdeficient adults has become a clinical reality and its effectiveness has been sufficiently demonstrated by its ability to reverse most of the clinical manifestations of GH deficiency syndrome in adults. Experience has allowed us to differentiate between adults presenting deficiency before the end of growth and puberty and those who subsequently become deficient. The differences are not only etiologic; phenotypic characteristics and response to treatment also differ. In the present article we review the different types of presentation according to their onset and the effects of body composition, bone mineral density, health-related quality of life, and lipid profile when GH therapy is discontinued after final height has been achieved. We also evaluate the results of the reintroduction of GH therapy in adults in whom the therapy was discontinued on reaching final height.
Key words:
Growth hormone deficiency in adults
Hypopituitarism
Growth hormone
Treatment
Body composition
Health-related quality of life
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