Growth Hormone Deficiency

Definition

Growth Hormone Deficiency (GHD) is a condition characterized by insufficient secretion of growth hormone (GH) from the pituitary gland, leading to impaired growth in children and metabolic disturbances in adults.

Epidemiology

• Congenital GHD is rare, with incidence ~1 in 4,000–10,000 live births
• Acquired GHD can occur at any age due to pituitary tumors, trauma, or radiation
• Equal prevalence in males and females in congenital cases
• Adult GHD often underdiagnosed and associated with metabolic syndrome

Etiology

• Congenital: genetic mutations affecting GH1, GHRH receptor, or pituitary development
• Acquired: pituitary tumors, trauma, infection, radiation therapy, Sheehan syndrome
• Idiopathic: isolated GHD without identifiable cause
• Combined pituitary hormone deficiencies

Pathophysiology

• Deficiency of GH → reduced stimulation of hepatic IGF-1 production
• IGF-1 deficiency → impaired linear growth in children
• Altered metabolism: increased fat mass, decreased lean body mass, dyslipidemia
• Delayed bone age and skeletal maturation in children
• Adult GHD: reduced exercise tolerance, impaired cardiac function, psychological symptoms