Pre-treatment IGF-I level is the major determinant of GH dosage in adult GH deficiency

摘要: OBJECTIVE Severe GH deficiency in adults is a definite clinical entity, the effects of which can be reversed by administration subcutaneous recombinant GH. The ideal dosing regimen and determinants maintenance dose have, however, yet to elucidated. PATIENTS In an open study replacement we treated 65 GH-deficient mixed adult- childhood-onset, mean age 35.5 (range 17–72) years, comprising 38 females 27 males, using individualized low-dose titration aimed at normalization serum IGF-I induction improvement. RESULTS Before initiation therapy, median SD was significantly lower female than male patients (− 3.3 vs. − 1.9, P = 0.007) childhood-onset compared with adult-onset (− 3.9 − 2.0, P < 0.001). Once dosage had been achieved, requirement greater (1.6 0.8 IU/day, P = 0.013) P = 0.019). for cohort overall 1.2 0.4–2.4) IU/day. By univariate analysis significant negative correlation observed between baseline (r = - 0.63, No demonstrated either or weight. Multiple linear regression age, gender, weight, time onset deficiency, peak insulin tolerance test (ITT) as independent variables account 51% variation required normalize (P < 0.001). Those therapy dose. None other studied influenced dose. CONCLUSION We have that individual dependent on before commencement replacement. In contrast, severity judged response ITT unrelated requirement. effect gender final are accounted pretreatment young, relative older, patients, respectively.