Erişkinde büyüme hormonu eksikliğinin değerlendirilmesi ve tedavisi

Erişkinde büyüme hormonu eksikliğ i, klinik, biyokimyasal ve metabolik bozukluklarla seyreden kompleks bir sendromdur. Eriş kin ya ş grubunda eksikliğ e neden olan en önemli sebep, yapı sal lezyonlar ve travmad ı r. Çocukluk ça ğ ı ba ş lang ı çl ı olgular, erişkin boya ula ştı ktan sonra tedavinin devam ı aç ı sı ndan tekrar test edilmelidir. Büyüme hormonu eksikliğ i tan ı s ı nda tek ba ş ı na bazal hormon düzeyi ölçümü yeterli de ğ ildir. Tan ı için uyar ı testlerinin (insülin tolerans testi, GHRH-arginin testi, glukagon stimülasyon testi gibi) kullan ı lmas ı ve klinik bulgular ı n da de ğ erlendirilmesi gerekmektedir. Erişkinde tedavinin yararlar ı , vücut kompozisyonu, kemik sa ğ l ı ğ ı , kardiyovasküler risk faktörleri ve hayat kalitesi üzerinde görülmektedir. Tedaviye yan ı tı de ğ erlendirirken klinik iyile şme derecesi, yan etki durumu ve IGF-1 düzeyi göz önünde bulundurulmal ı d ı r. Büyüme hormonu tedavisi ile ilgili maliyet-etkililik çal ı şmaları ndaki kan ı tlar net de ğ ildir. Büyüme hormonu eksikliğ i olan her hasta tedavi edilmemelidir.

The evaluation and the treatment of the growth hormone deficiency in adults

Growth hormone deficiency in adults is a complex syndrome accompanied by clinical, biochemical and metabolic anomalies. The most important factors leading to the growth hormone deficiency are structural lesions and trauma. Cases with their roots in childhood must be re-analyzed in order to proceed with the treatment in adulthood. For the diagnosis of the growth hormone deficiency, basal hormone is not sufficient on its own. For diagnosis, stimulant tests (insulin tolerance test, GHRH-arginin test, glucagon stimulant test) must also be used. Treatment benefits in adults can be observed in body composition, bone health, cardiovascular risk factors and quality of life. Response to the treatment must be evaluated together with the degree of clinical recovery, side effect status, and the level of IGF-1. The proofs in cost-effectiveness studies about the treatment of the growth hormone deficiency are not clear. Every patient with the growth hormone deficiency must not be treated.

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