{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T13:38:31Z","timestamp":1791639511593,"version":"4.3.4"},"reference-count":200,"publisher":"Oxford University Press (OUP)","issue":"1","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:p>The acute metabolic actions of purified human growth hormone (GH) were first documented in adult hypopituitary patients more than 50 years ago, and placebo-controlled long-term GH trials in GH-deficient adults (GHDA) surfaced in 1989 with the availability of biosynthetic human GH. Untreated GHDA is associated with excess morbidity and mortality from cardiovascular disease and the phenotype includes fatigue, reduced aerobic exercise capacity, abdominal obesity, reduced lean body mass, osteopenia and elevated levels of circulating cardiovascular biomarkers. Several of these features reverse and normalize with GH replacement. It remains controversial whether quality of life, assessed by questionnaires, improves. The known side effects are fluid retention and insulin resistance, which are reversible and dose dependent. The dose requirement declines markedly with age and is higher in women. Continuation of GH replacement into adulthood in patients with childhood-onset disease is indicated, if the diagnosis is reconfirmed. GH treatment of frail elderly subjects without documented pituitary disease remains unwarranted. Observational data show that mortality in GH-replaced patients is reduced compared to untreated patients. Even though this reduced mortality could be due to selection bias, GH replacement in GHDA has proven beneficial and safe.<\/jats:p>","DOI":"10.1530\/eje-18-0306","type":"journal-article","created":{"date-parts":[[2018,5,1]],"date-time":"2018-05-01T11:25:54Z","timestamp":1525173954000},"page":"R47-R56","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":50,"title":["THERAPY OF ENDOCRINE DISEASE: Growth hormone replacement therapy in adults: 30 years of personal clinical experience"],"prefix":"10.1093","volume":"179","author":[{"given":"Jens O L","family":"J\u00f8rgensen","sequence":"first","affiliation":[{"name":"1Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Juul","sequence":"additional","affiliation":[{"name":"2Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","reference":[{"key":"ref1231","first-page":"309","article-title":"Treatment of adults with growth hormone (GH) deficiency with recombinant human GH","volume":"76","year":"1993","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"ref121","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1530\/eje.0.1310041","article-title":"Growth hormone (GH) treatment increases serum insulin-like growth factor binding protein-3, bone isoenzyme alkaline phosphatase and forearm bone mineral content in young adults with GH deficiency of childhood onset","volume":"131","year":"1994","journal-title":"European Journal of Endocrinology"},{"key":"ref871","article-title":"Cancer Incidence in Patients with Acromegaly: a cohort study and meta-analysis of the literature","year":"2018","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"ref911","doi-asserted-by":"crossref","first-page":"2912","DOI":"10.1210\/jc.2011-1377","article-title":"Meta-analysis and dose-response metaregression: circulating insulin-like growth factor I (IGF-I) and mortality","volume":"96","year":"2011","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"ref1751","first-page":"4516","article-title":"Discontinuation of growth hormone (GH) treatment: metabolic effects in GH-deficient and GH-sufficient adolescent patients compared with control subjects. 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