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International Journal of Endocrinology
Volume 2012 (2012), Article ID 972617, 7 pages
http://dx.doi.org/10.1155/2012/972617
Review Article

Diagnosing Growth Hormone Deficiency in Adults

Department of Endocrinology, Beaumont Hospital, RCSI Medical School, Dublin 9, Ireland

Received 6 March 2012; Revised 14 June 2012; Accepted 15 June 2012

Academic Editor: Maria L. Dufau

Copyright © 2012 Nigel Glynn and Amar Agha. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Adult growth hormone (GH) deficiency is a recognised syndrome associated with adverse phenotypic, metabolic, and quality-of-life features which improve in many patients when GH is substituted. The appropriate selection of patients at risk of growth hormone deficiency (GHD) is the crucial first step in arriving at a correct diagnosis. Although multiple diagnostic modalities are available including a 24-hour serum GH profile, stimulated GH levels, and insulin-like growth factor-1 (IGF-1) levels, the use of dynamic tests for GH reserves is required in most cases. This paper discusses the utility and drawbacks of the various testing modalities with reference to international guidelines. Regardless of the test chosen, clinical pitfalls including age and obesity must be taken into account. In addition, there is considerable analytical variation in the biochemical measurements of GH and IGF-1 which must be considered before making a diagnosis of GHD in adulthood.