{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T16:27:11Z","timestamp":1762100831166},"reference-count":42,"publisher":"FapUNIFESP (SciELO)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq Bras Endocrinol Metab"],"published-print":{"date-parts":[[2008,7]]},"abstract":"<jats:p>OBJETIVO: Avaliar a efic\u00e1cia, a seguran\u00e7a e a ader\u00eancia de quatro anos de tratamento com GH em 18 adultos [12 mulheres, 6 homens, com idade m\u00e9dia de 50,5 anos (25-66 anos)] com defici\u00eancia grave de GH (DGH). M\u00c9TODOS: Avalia\u00e7\u00f5es cl\u00ednica, laboratorial e de composi\u00e7\u00e3o corporal (DXA) realizadas antes e anualmente ap\u00f3s o in\u00edcio do GH, e ecocardiografia realizada antes e ap\u00f3s quatro anos de tratamento. Dose de 0,2 mg GH\/dia mantida fixa no primeiro ano, com posteriores ajustes para normalizar IGF-1. RESULTADOS: Redu\u00e7\u00e3o significativa da gordura corporal total (m\u00e9dia 2,8 kg) e da gordura truncal (m\u00e9dia 1,9 kg), associadas com aumento da massa magra (m\u00e9dia 0,8 kg) e aumento da densidade mineral \u00f3ssea (DMO) em coluna lombar e f\u00eamur, particularmente nos s\u00edtios com T-escore menor que 1,0 na avalia\u00e7\u00e3o basal. Houve piora dos n\u00edveis de insulina e HOMA no primeiro ano de terapia, mas ao final do quarto ano os valores de glicose, insulina, HOMA e hemoglobina glicosilada n\u00e3o eram diferentes dos basais. Desenvolveram diabetes tipo 2 no seguimento dois pacientes com intoler\u00e2ncia \u00e0 glicose pr\u00e9-tratamento. O colesterol total e o LDL colesterol reduziram significativamente, e as mudan\u00e7as foram proporcionais aos valores basais. Os par\u00e2metros ecocardiogr\u00e1ficos n\u00e3o se alteraram. Os efeitos colaterais foram leves e bem tolerados. N\u00e3o foi observada recorr\u00eancia tumoral. Baixa ades\u00e3o ao tratamento (estimada por n\u00edveis baixos de IGF-1) ocorreu em quatro (22%), dois (11%) e seis (30%) pacientes ao final do segundo, terceiro e quarto ano, respectivamente. CONCLUS\u00d5ES: Quatro anos de tratamento com GH em adultos com DGH teve impacto positivo sobre a composi\u00e7\u00e3o corporal, a DMO e o perfil lip\u00eddico, e nenhum efeito sobre sensibilidade insul\u00ednica e o cora\u00e7\u00e3o. A intoler\u00e2ncia \u00e0 glicose deve ser cuidadosamente monitorada no tratamento de longo prazo.<\/jats:p>","DOI":"10.1590\/s0004-27302008000500021","type":"journal-article","created":{"date-parts":[[2008,9,29]],"date-time":"2008-09-29T14:04:16Z","timestamp":1222697056000},"page":"879-888","source":"Crossref","is-referenced-by-count":5,"title":["Efic\u00e1cia, seguran\u00e7a e ader\u00eancia ao tratamento de longo prazo com horm\u00f4nio de crescimento (GH) em adultos com defici\u00eancia de GH"],"prefix":"10.1590","volume":"52","author":[{"given":"Daniele C. T.","family":"Zaninelli","sequence":"first","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ludimyla H. F.","family":"Meister","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosana B.","family":"Radominski","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria Z. C.","family":"Borba","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Admar Moraes","family":"Souza","sequence":"additional","affiliation":[{"name":"UFPR, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cesar L.","family":"Boguszewski","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/S1096-6374(98)80005-1","article-title":"The Growth Hormone Research Society consensus guidelines for the diagnosis and treatment of adult GH deficiency","volume":"8","author":"Hartman ML","year":"1998","journal-title":"Growth Horm IGF Res"},{"key":"ref2","first-page":"1","article-title":"GRS council: Growth hormone replacement therapy for adults: into the new millennium. 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