| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Clinical Studies |
Lilly Research Centre, Erl Wood Manor (A.F.A., A.M.C.M., M.A.B., P.C.B.), Windlesham, Surrey GU20 6PH, United Kingdom; Erasmus University (S.W.J.L., N.K.V.), 3015 GD Rotterdam, The Netherlands; Department of Internal Medicine & Endocrinology, Hvidovre Hospital (J.H.), DK-2650 Hvidovre, Denmark; Research Centre for Endocrinology & Metabolism, Sahlgrenska University Hospital (B.B.), Goteborg, Sweden; and Medizinische Klinik Innenstadt (C.J.S.), Munchen, Germany
Address all correspondence and requests for reprints to: Steven W.J. Lamberts, University Hospital Dijkzigt, 40 Dr Molewaterplein, 3015 GD Rotterdam, The Netherlands.
The onset of adult GH deficiency may be during either adulthood (AO) or childhood (CO), but potential differences have not previously been examined. In this study the baseline and GH therapy (12.5 µg/kg per day) data from CO (n = 74; mean age 29 yr) and AO (n = 99; mean age 44 yr) GH- deficient adult patients have been compared. The first 6 months comprised randomized, double-blind treatment with GH or placebo, then all patients were GH-treated for a further 12 months.
At baseline the height, body weight, body mass index, lean body mass, and waist/hip ratio of AO patients were significantly (P < 0.001) greater than in CO patients. Serum insulin-like growth factor-I (IGF-I) levels were below normal but were lower in CO than AO patients (P < 0.001), and the correlation with IGF binding protein-3 was stronger in CO than in AO patients. Osteocalcin concentration in CO patients was above the normal range and significantly greater than in AO patients. Both groups had significant psychosocial distress, but the deviation from normality was greater in AO patients. Throughout GH therapy there was a significant increase in lean body mass and significant decrease in percent body fat and sum of skinfolds in each group. Waist/hip ratio was decreased by long-term therapy in AO but not CO patients. Total and low density lipoprotein cholesterol levels were decreased from baseline at 6 months in AO but not CO patients and high density lipoprotein cholesterol was increased in both groups throughout therapy. IGF-I and IGF binding protein-3 were increased into the normal range by GH therapy in both groups. Mean osteocalcin level in AO patients was increased at 6 months with no further change with GH therapy, whereas in CO patients there was a steep increase up to 12 months but then a sharp decrease. Nottingham Health Profile scores showed significant improvements in physical mobility and energy at 18 months of therapy in AO patients but no consistent effects in CO patients. GH-induced side effects were mainly reported by AO patients; very few CO patients reported treatment-emergent adverse events.
These results demonstrate significant differences in clinical and biochemical presentation and responses to therapy of the adult GH deficiency syndrome. This is consistent with the existence of two entities, developmental (CO) and metabolic (AO), and the different functions of GH at different periods of life.
This article has been cited by other articles:
 |
|
 |
|
  V Gasco, G Corneli, G Beccuti, F Prodam, S Rovere, J Bellone, S Grottoli, G Aimaretti, and E Ghigo Retesting the childhood-onset GH-deficient patient Eur. J. Endocrinol., December 1, 2008; 159(suppl_1): S45 - S52. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Giustina, G. Mazziotti, and E. Canalis Growth Hormone, Insulin-Like Growth Factors, and the Skeleton Endocr. Rev., August 1, 2008; 29(5): 535 - 559. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. L. Hartman, A. Weltman, A. Zagar, R. L. Qualy, A. R. Hoffman, and G. R. Merriam Growth Hormone Replacement Therapy in Adults with Growth Hormone Deficiency Improves Maximal Oxygen Consumption Independently of Dosing Regimen or Physical Activity J. Clin. Endocrinol. Metab., January 1, 2008; 93(1): 125 - 130. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Stochholm, C. H. Gravholt, T. Laursen, P. Laurberg, M. Andersen, L. O. Kristensen, U. Feldt-Rasmussen, J. S. Christiansen, M. Frydenberg, and A. Green Mortality and GH deficiency: a nationwide study Eur. J. Endocrinol., July 1, 2007; 157(1): 9 - 18. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Urushihara, S. Fukuhara, S. Tai, S. Morita, and K. Chihara Heterogeneity in responsiveness of perceived quality of life to body composition changes between adult- and childhood-onset Japanese hypopituitary adults with GH deficiency during GH replacement Eur. J. Endocrinol., June 1, 2007; 156(6): 637 - 645. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Radovick and S. DiVall Approach to the Growth Hormone-Deficient Child during Transition to Adulthood J. Clin. Endocrinol. Metab., April 1, 2007; 92(4): 1195 - 1200. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Abs, U. Feldt-Rasmussen, A. F Mattsson, J. P Monson, B.-A. Bengtsson, M. I Goth, P. Wilton, and M. Koltowska-Haggstrom Determinants of cardiovascular risk in 2589 hypopituitary GH-deficient adults - a KIMS database analysis. Eur. J. Endocrinol., July 1, 2006; 155(1): 79 - 90. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Svensson, G. Johannsson, A. Iranmanesh, K. Albertsson-Wikland, J. D Veldhuis, and B.-A. Bengtsson GH secretory pattern in young adults who discontinued GH treatment for GH deficiency and decreased longitudinal growth in childhood. Eur. J. Endocrinol., July 1, 2006; 155(1): 91 - 99. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. J. Woodhouse, A. Mukherjee, S. M. Shalet, and S. Ezzat The Influence of Growth Hormone Status on Physical Impairments, Functional Limitations, and Health-Related Quality of Life in Adults Endocr. Rev., May 1, 2006; 27(3): 287 - 317. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. E. Molitch, D. R. Clemmons, S. Malozowski, G. R. Merriam, S. M. Shalet, M. L. Vance, and for The Endocrine Society's Clinical Guidelines Su Evaluation and Treatment of Adult Growth Hormone Deficiency: An Endocrine Society Clinical Practice Guideline J. Clin. Endocrinol. Metab., May 1, 2006; 91(5): 1621 - 1634. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. R Christ, M. H Cummings, M. Stolinski, N. Jackson, P. J Lumb, A. S Wierzbicki, P. H Sonksen, D. L Russell-Jones, and A M. Umpleby Low-density lipoprotein apolipoprotein B100 turnover in hypopituitary patients with GH deficiency: a stable isotope study. Eur. J. Endocrinol., March 1, 2006; 154(3): 459 - 466. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Mukherjee, J. E Adams, L. Smethurst, and S. M Shalet Interdependence of lean body mass and total body water, but not quality of life measures, during low dose GH replacement in GH-deficient adults Eur. J. Endocrinol., November 1, 2005; 153(5): 661 - 668. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Svensson, B. Soderpalm, K. Sjogren, J. Engel, and C. Ohlsson Liver-derived IGF-I regulates exploratory activity in old mice Am J Physiol Endocrinol Metab, September 1, 2005; 289(3): E466 - E473. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. F. Attanasio, E. P. Shavrikova, W. F. Blum, and S. M. Shalet Quality of Life in Childhood Onset Growth Hormone-Deficient Patients in the Transition Phase from Childhood to Adulthood J. Clin. Endocrinol. Metab., August 1, 2005; 90(8): 4525 - 4529. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Vigano, S. Mora, P. Manzoni, L. Schneider, S. Beretta, M. Molinaro, B. di Natale, and P. Brambilla Effects of Recombinant Growth Hormone on Visceral Fat Accumulation: Pilot Study in Human Immunodeficiency Virus-Infected Adolescents J. Clin. Endocrinol. Metab., July 1, 2005; 90(7): 4075 - 4080. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Mauras, O. H. Pescovitz, V. Allada, M. Messig, M. P. Wajnrajch, B. Lippe, and on behalf of the Transition Study Group Limited Efficacy of Growth Hormone (GH) during Transition of GH-Deficient Patients from Adolescence to Adulthood: A Phase III Multicenter, Double-Blind, Randomized Two-Year Trial J. Clin. Endocrinol. Metab., July 1, 2005; 90(7): 3946 - 3955. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Kendall-Taylor, P. J Jonsson, R. Abs, E. M. Erfurth, M. Koltowska-Haggstrom, D. A. Price, and J. Verhelst The clinical, metabolic and endocrine features and the quality of life in adults with childhood-onset craniopharyngioma compared with adult-onset craniopharyngioma Eur. J. Endocrinol., April 1, 2005; 152(4): 557 - 567. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Gola, S. Bonadonna, M. Doga, and A. Giustina Growth Hormone and Cardiovascular Risk Factors J. Clin. Endocrinol. Metab., March 1, 2005; 90(3): 1864 - 1870. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Mukherjee, S. Tolhurst-Cleaver, W. D. J. Ryder, L. Smethurst, and S. M. Shalet The Characteristics of Quality of Life Impairment in Adult Growth Hormone (GH)-Deficient Survivors of Cancer and Their Response to GH Replacement Therapy J. Clin. Endocrinol. Metab., March 1, 2005; 90(3): 1542 - 1549. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Reis, M. V. Campos, M. Bastos, L. Almeida, M. Lourenco, C. A. Ferrer-Antunes, A. Palmeiro, J. D. Santos-Dias, J. F. Mesquita, M. Carvalheiro, et al. Platelet Hyperactivation in Maintained Growth Hormone-Deficient Childhood Patients after Therapy Withdrawal as a Putative Earlier Marker of Increased Cardiovascular Risk J. Clin. Endocrinol. Metab., January 1, 2005; 90(1): 98 - 105. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. F. Attanasio, E. Shavrikova, W. F. Blum, M. Cromer, C. J. Child, M. Paskova, J. Lebl, J. J. Chipman, the Hypopituitary Developmental Outcome Study Grou, and S. M. Shalet Continued Growth Hormone (GH) Treatment after Final Height Is Necessary to Complete Somatic Development in Childhood-Onset GH-Deficient Patients J. Clin. Endocrinol. Metab., October 1, 2004; 89(10): 4857 - 4862. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. V. Carroll, W. M. Drake, K. T. Maher, K. Metcalfe, N. J. Shaw, D. B. Dunger, T. D. Cheetham, C. Camacho-Hubner, M. O. Savage, and J. P. Monson Comparison of Continuation or Cessation of Growth Hormone (GH) Therapy on Body Composition and Metabolic Status in Adolescents with Severe GH Deficiency at Completion of Linear Growth J. Clin. Endocrinol. Metab., August 1, 2004; 89(8): 3890 - 3895. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. R. Hoffman, C. J. Strasburger, A. Zagar, W. F. Blum, A. Kehely, and M. L. Hartman Efficacy and Tolerability of an Individualized Dosing Regimen for Adult Growth Hormone Replacement Therapy in Comparison with Fixed Body Weight-Based Dosing J. Clin. Endocrinol. Metab., July 1, 2004; 89(7): 3224 - 3233. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Maison, S. Griffin, M. Nicoue-Beglah, N. Haddad, B. Balkau, and P. Chanson Impact of Growth Hormone (GH) Treatment on Cardiovascular Risk Factors in GH-Deficient Adults: A Metaanalysis of Blinded, Randomized, Placebo-Controlled Trials J. Clin. Endocrinol. Metab., May 1, 2004; 89(5): 2192 - 2199. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Hayakawa, Y. Shimazaki, T. Tsushima, Y. Kato, K. Takano, K. Chihara, A. Shimatsu, and M. Irie Metabolic Effects of 20-Kilodalton Human Growth Hormone (20K-hGH) for Adults with Growth Hormone Deficiency: Results of an Exploratory Uncontrolled Multicenter Clinical Trial of 20K-hGH J. Clin. Endocrinol. Metab., April 1, 2004; 89(4): 1562 - 1571. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Rosilio, W. F. Blum, D. J. Edwards, E. P. Shavrikova, D. Valle, S. W. J. Lamberts, E. M. Erfurth, S. M. Webb, R. J. Ross, K. Chihara, et al. Long-Term Improvement of Quality of Life During Growth Hormone (GH) Replacement Therapy in Adults with GH Deficiency, as Measured by Questions on Life Satisfaction-Hypopituitarism (QLS-H) J. Clin. Endocrinol. Metab., April 1, 2004; 89(4): 1684 - 1693. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Tauber, B. Jouret, A. Cartault, N. Lounis, M. Gayrard, C. Marcouyeux, C. Pienkowski, I. Oliver, P. Moulin, P. Otal, et al. Adolescents with Partial Growth Hormone (GH) Deficiency Develop Alterations of Body Composition after GH Discontinuation and Require Follow-Up J. Clin. Endocrinol. Metab., November 1, 2003; 88(11): 5101 - 5106. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. E. Underwood, K. M. Attie, and J. Baptista Growth Hormone (GH) Dose-Response in Young Adults with Childhood-Onset GH Deficiency: A Two-Year, Multicenter, Multiple-Dose, Placebo-Controlled Study J. Clin. Endocrinol. Metab., November 1, 2003; 88(11): 5273 - 5280. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. F. Blum, E. P. Shavrikova, D. J. Edwards, M. Rosilio, M. L. Hartman, F. Marin, D. Valle, A. J. van der Lely, A. F. Attanasio, C. J. Strasburger, et al. Decreased Quality of Life in Adult Patients with Growth Hormone Deficiency Compared with General Populations Using the New, Validated, Self-Weighted Questionnaire, Questions on Life Satisfaction Hypopituitarism Module J. Clin. Endocrinol. Metab., September 1, 2003; 88(9): 4158 - 4167. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. L. Isley Growth Hormone Therapy for Adults: Not Ready for Prime Time? Ann Intern Med, August 6, 2002; 137(3): 190 - 196. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. F. Attanasio, S. Howell, P. C. Bates, P. Frewer, J. Chipman, W. F. Blum, and S. M. Shalet Body Composition, IGF-I and IGFBP-3 Concentrations as Outcome Measures in Severely GH-Deficient (GHD) Patients after Childhood GH Treatment: A Comparison with Adult Onset GHD Patients J. Clin. Endocrinol. Metab., July 1, 2002; 87(7): 3368 - 3372. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Ezzat, S. Fear, R.-C. Gaillard, C. Gayle, H. Landy, S. Marcovitz, T. Mattioni, S. Nussey, A. Rees, and E. Svanberg Gender-Specific Responses of Lean Body Composition and Non-Gender-Specific Cardiac Function Improvement after GH Replacement in GH-Deficient Adults J. Clin. Endocrinol. Metab., June 1, 2002; 87(6): 2725 - 2733. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Kehely, P. C. Bates, P. Frewer, M. Birkett, W. F. Blum, P. Mamessier, S. Ezzat, K. K. Y. Ho, G. Lombardi, A. Luger, et al. Short-Term Safety and Efficacy of Human GH Replacement Therapy in 595 Adults with GH Deficiency: A Comparison of Two Dosage Algorithms J. Clin. Endocrinol. Metab., May 1, 2002; 87(5): 1974 - 1979. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. F. Attanasio, P. C. Bates, K. K. Y. Ho, S. M. Webb, R. J. Ross, C. J. Strasburger, R. Bouillon, B. Crowe, K. Selander, D. Valle, et al. Human Growth Hormone Replacement in Adult Hypopituitary Patients: Long-Term Effects on Body Composition and Lipid Status--3-Year Results from the HypoCCS Database J. Clin. Endocrinol. Metab., April 1, 2002; 87(4): 1600 - 1606. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. D. Murray, K. H. Darzy, H. K. Gleeson, and S. M. Shalet GH-Deficient Survivors of Childhood Cancer: GH Replacement during Adult Life J. Clin. Endocrinol. Metab., January 1, 2002; 87(1): 129 - 135. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. M. McConnell, A. B. Atkinson, C. Ennis, D. R. Hadden, D. R. McCance, B. Sheridan, and P. M. Bell The Effects on Insulin Action in Adult Hypopituitarism of Recombinant Human GH Therapy Individually Titrated for Six Months J. Clin. Endocrinol. Metab., November 1, 2001; 86(11): 5342 - 5347. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Koranyi, J. Svensson, G. Gotherstrom, K. S. Sunnerhagen, B.-A. Bengtsson, and G. Johannsson Baseline Characteristics and the Effects of Five Years of GH Replacement Therapy in Adults with GH Deficiency of Childhood or Adulthood Onset: A Comparative, Prospective Study J. Clin. Endocrinol. Metab., October 1, 2001; 86(10): 4693 - 4699. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. P. Goldstone, E. L. Thomas, A. E. Brynes, J. D. Bell, G. Frost, N. Saeed, J. V. Hajnal, J. K. Howard, A. Holland, and S. R. Bloom Visceral Adipose Tissue and Metabolic Complications of Obesity Are Reduced in Prader-Willi Syndrome Female Adults: Evidence for Novel Influences on Body Fat Distribution J. Clin. Endocrinol. Metab., September 1, 2001; 86(9): 4330 - 4338. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. M. Drake, S. J. Howell, J. P. Monson, and S. M. Shalet Optimizing GH Therapy in Adults and Children Endocr. Rev., August 1, 2001; 22(4): 425 - 450. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Wiren, G. Johannsson, and B.-A. Bengtsson A Prospective Investigation of Quality of Life and Psychological Well-Being after the Discontinuation of GH Treatment in Adolescent Patients Who Had GH Deficiency during Childhood J. Clin. Endocrinol. Metab., August 1, 2001; 86(8): 3494 - 3498. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Marzullo, C. Di Somma, K. L. Pratt, J. Khosravi, A. Diamandis, G. Lombardi, A. Colao, and R. G. Rosenfeld Usefulness of Different Biochemical Markers of the Insulin-Like Growth Factor (IGF) Family in Diagnosing Growth Hormone Excess and Deficiency in Adults J. Clin. Endocrinol. Metab., July 1, 2001; 86(7): 3001 - 3008. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Colao, C. di Somma, A. Cuocolo, L. Spinelli, N. Tedesco, R. Pivonello, D. Bonaduce, M. Salvatore, and G. Lombardi Improved Cardiovascular Risk Factors and Cardiac Performance after 12 Months of Growth Hormone (GH) Replacement in Young Adult Patients with GH Deficiency J. Clin. Endocrinol. Metab., May 1, 2001; 86(5): 1874 - 1881. [Abstract] [Full Text]
|
|
|
|
|
|
A. L. Barkan The "Quality of Life-Assessment of Growth Hormone Deficiency in Adults" Questionnaire: Can It Be Used to Assess Quality of Life in Hypopituitarism? J. Clin. Endocrinol. Metab., May 1, 2001; 86(5): 1905 - 1907. [Abstract] [Full Text]
|
|
|
|
|
|
R. Dall, S. Longobardi, C. Ehrnborg, N. Keay, T. Rosén, J. O. L. Jørgensen, R. C. Cuneo, M. A. Boroujerdi, A. Cittadini, R. Napoli, et al. The Effect of Four Weeks of Supraphysiological Growth Hormone Administration on the Insulin-Like Growth Factor Axis in Women and Men J. Clin. Endocrinol. Metab., November 1, 2000; 85(11): 4193 - 4200. [Abstract] [Full Text]
|
|
|
|
|
|
G. Aimaretti, C. Baffoni, S. Bellone, L. Di Vito, G. Corneli, E. Arvat, L. Benso, F. Camanni, and E. Ghigo Retesting Young Adults with Childhood-Onset Growth Hormone (GH) Deficiency with GH-Releasing-Hormone-Plus-Arginine Test J. Clin. Endocrinol. Metab., October 1, 2000; 85(10): 3693 - 3699. [Abstract] [Full Text]
|
|
|
|
|
|
G. Sesmilo, B. M.K. Biller, J. Llevadot, D. Hayden, G. Hanson, N. Rifai, and A. Klibanski Effects of Growth Hormone Administration on Inflammatory and Other Cardiovascular Risk Markers in Men with Growth Hormone Deficiency: A Randomized, Controlled Clinical Trial Ann Intern Med, July 18, 2000; 133(2): 111 - 122. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. M. Beentjes, A. van Tol, W. J. Sluiter, and R. P. F. Dullaart Effect of growth hormone replacement therapy on plasma lecithin:cholesterol acyltransferase and lipid transfer protein activities in growth hormone-deficient adults J. Lipid Res., June 1, 2000; 41(6): 925 - 932. [Abstract] [Full Text]
|
|
|
|
|
|
N. Vahl, A. Juul, J. O. L. Jørgensen, H. Ørskov, N. E. Skakkebæk, and Jens. S. Christiansen Continuation of Growth Hormone (GH) Replacement in GH-Deficient Patients during Transition from Childhood to Adulthood: A Two-Year Placebo-Controlled Study J. Clin. Endocrinol. Metab., May 1, 2000; 85(5): 1874 - 1881. [Abstract] [Full Text]
|
|
|
|
|
|
B.-A. Bengtsson and G. Johannsson The Treatment of Growth Hormone Deficiency in Adults J. Clin. Endocrinol. Metab., March 1, 2000; 85(3): 933 - 937. [Full Text]
|
|
|
|
|
|
B. M. K. Biller, G. Sesmilo, H. B. A. Baum, D. Hayden, D. Schoenfeld, and A. Klibanski Withdrawal of Long-Term Physiological Growth Hormone (GH) Administration: Differential Effects on Bone Density and Body Composition in Men with Adult-Onset GH Deficiency J. Clin. Endocrinol. Metab., March 1, 2000; 85(3): 970 - 976. [Abstract] [Full Text]
|
|
|
|
|
|
Discontinuation of Growth Hormone (GH) Treatment: Metabolic Effects in GH-Deficient and GH-Sufficient Adolescent Patients Compared with Control Subjects J. Clin. Endocrinol. Metab., December 1, 1999; 84(12): 4516 - 4524. [Abstract] [Full Text]
|
|
|
|
 |
|
 M. L. Vance and N. Mauras Growth Hormone Therapy in Adults and Children N. Engl. J. Med., October 14, 1999; 341(16): 1206 - 1216. [Full Text] [PDF]
|
|
|
|
|
|
J. Gibney, J. D. Wallace, T. Spinks, L. Schnorr, A. Ranicar, R. C. Cuneo, S. Lockhart, K. G. Burnand, F. Salomon, P. H. Sonksen, et al. The Effects of 10 Years of Recombinant Human Growth Hormone (GH) in Adult GH-Deficient Patients J. Clin. Endocrinol. Metab., August 1, 1999; 84(8): 2596 - 2602. [Abstract] [Full Text]
|
|
|
|
|
|
J. Khosravi, A. Diamandi, J. Mistry, and R. G. Krishna The High Molecular Weight Insulin-Like Growth Factor-Binding Protein Complex: Epitope Mapping, Immunoassay, and Preliminary Clinical Evaluation J. Clin. Endocrinol. Metab., August 1, 1999; 84(8): 2826 - 2833. [Abstract] [Full Text]
|
|
|
|
|
|
J. C. ter Maaten, H. de Boer, O. Kamp, L. Stuurman, and E. A. van der Veen Long-Term Effects of Growth Hormone (GH) Replacement in Men with Childhood-Onset GH Deficiency J. Clin. Endocrinol. Metab., July 1, 1999; 84(7): 2373 - 2380. [Abstract] [Full Text]
|
|
|
|
|
|
A. Hilding, K. Hall, I.-L. Wivall-Helleryd, M. Sääf, A.-L. Melin, and M. Thorén Serum Levels of Insulin-Like Growth Factor I in 152 Patients with Growth Hormone Deficiency, Aged 19-82 Years, in Relation to Those in Healthy Subjects J. Clin. Endocrinol. Metab., June 1, 1999; 84(6): 2013 - 2019. [Abstract] [Full Text]
|
|
|
|
