Growth hormone therapy in children and adults

Growth hormone is responsible for growth in childhood after the first one to two years, and its deficiency results in short stature. Use of GH has been restricted over the years, initially due to scarcity of supply (human pituitary GH), and thereafter due to expense of the drug (synthetic GH).  In the UK, GH is licensed for the treatment of children with GHD, TS, PWS, CRI, and those born SGA who fail to catch up in growth.  In some countries GH is used for other indications, and it is also used off-license in the UK for treatment of other conditions (primarily ‘short stature syndromes’). Growth hormone plays an important role in determining peak bone mass in adolescence/early adulthood, and has an important metabolic role in adults. Growth  hormone  deficiency  in  adults  leads  to  lack  of  energy, abnormal  body  composition (reduced  lean  mass, increased  fat  mass), adverse  cardiovascular  factors  (elevated  cholesterol and triglycerides, abnormal echocardiography, hypertension), and reduced insulin sensitivity. It is thus associated with reduced quality of life and increased cardiovascular risk.