Adult Growth Hormone Insufficiency (AGHI) is a recognized clinical syndrome characterized by a deficiency in the secretion of pituitary growth hormone (GH) in patients who have reached full skeletal maturity. This endocrine disorder results in a spectrum of adverse changes in body composition, lipid metabolism, and overall quality of life. Diagnosis typically requires provocative testing to confirm the inadequate GH reserve, distinguishing it from the normal age-related decline in GH secretion. The resulting hormonal imbalance impacts multiple organ systems, underscoring the importance of precise endocrine evaluation.
Origin
The concept originates from the field of endocrinology and human physiology, specifically focusing on the pituitary gland’s role in somatic growth and metabolic regulation beyond childhood. Clinical recognition of a distinct syndrome in adults, separate from childhood GH deficiency, emerged as researchers observed persistent metabolic and psychological sequelae after epiphyseal closure. This clinical term delineates a pathological state requiring intervention from the physiological reduction of somatotropin release that naturally occurs with aging.
Mechanism
The primary mechanism involves impaired pulsatile secretion of Growth Hormone from the anterior pituitary somatotrophs, often due to hypothalamic or pituitary structural damage, such as tumors or radiation therapy. Reduced GH signaling leads to a subsequent decrease in the hepatic production of Insulin-like Growth Factor-1 (IGF-1), which is the key mediator of many GH actions. This diminished somatotropic axis function disrupts fat distribution, reduces lean body mass, alters bone density, and negatively affects cardiovascular risk factors and psychological well-being.
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