The Epidemiology of Growth Hormone Deficiency

Abstract

The definition of growth hormone deficiency (GHD) has been disputed for decades. Pituitary disorders or the consequences of the treatment hereof can lead to GHD; however, numerous extrapituitary diseases or syndromes can result in GHD Guidelines and clarification have been published in order to shed more light on the issue. However, no standardized approach, which can be applied for currently diagnosed persons as well as recently diagnosed persons, exists. When focusing on the diagnosis of GHD, it seems important to differentiate between childhood-onset (CO) and adult-onset (AO) GHD. No arbitrary cut-off age exists, and in the guidelines, this is a clinical definition. Epidemiologically, this is not manageable and often 18 years is used as cut-off age. Data on incidence and prevalence are scarce; however, generally males seem to be diagnosed more often than. Morbidity is increased in patients with GHD; this applies both when focusing on clinical markers and in terms of admissions to hospitals. Similarly, studies from different countries have identified an increased mortality in various subgroups of GHD patients and in total. The increased mortality was especially due to cardiovascular diseases or cancer. The long-term consequences of growth hormone treatment on morbidity and mortality are not fully known; however, the treatment is considered safe except with regard to patients with active malignancy, in whom the treatment is contraindicated.