YOU ARE NOW CONNECTED TO THE TOXLINE (1981 FORWARD, NON-ROYALTY) FILE. ==SHORTNESS GROWTH HORMONE== 8 AUTHOR Neely EK AUTHOR Rosenfeld RG TITLE Use and abuse of human growth hormone. SOURCE Annu Rev Med; VOL 45, 1994, P407-20 (REF: 43) ABSTRACT Recombinant human growth hormone (hGH) has been available for nearly a decade. Side effects are rare. Its efficacy in promoting growth acceleration has been widely confirmed in children with GH deficiency (GHD), Turner syndrome, idiopathic short stature, chronic renal failure, and a variety of other conditions. The dramatic increase in height velocity in the first year of therapy partially attenuates in subsequent years in all patient groups, and convincing final height data are only available in GHD and Turner syndrome. Pediatric endocrinologists continue to be troubled by definitions of GHD. Although profound GHD is relatively obvious, other patients with severe growth failure but borderline or normal endocrine testing also respond to hGH therapy. Thus many endocrinologists use auxologic criteria [e.g. low growth velocity, height < -3 standard deviation (SD), poor predicted adult height] as the de facto basis for therapy, leading to a blurred distinction between treatment of disease and enhancement of normal characteristics and, finally, raising questions about the ultimate benefit of hGH therapy. Brief clinical trials of hGH therapy in adults both with and without GHD have reported increased muscle mass, decreased fat, and improvement in quality of life. Internists may soon be faced with treatment decisions analogous to those confronting pediatricians, i.e. whether to use hGH to repair aspects of the normal aging process. 3 AUTHOR Slyper A TITLE The safety and effectiveness of human growth hormone using pharmacological dosing. SOURCE Med Hypotheses; VOL 45, ISS 6, 1995, P523-8 (REF: 59) ABSTRACT Human growth hormone in currently recommended dosage is effective in many short children, irrespective of their endogenous growth-hormone status. This suggests that present dosing is pharmacological rather than physiological. As for any drug, issues of safety should be of paramount concern. Reassuring short-term data with pharmacological dosing or long-term data with replacement dosing cannot guarantee the ultimate safety of this form of therapy. The risk of future malignancy should be of particular concern. Poorly growing children without classic (severe) growth-hormone deficiency constitute an increasing proportion of children treated with human growth hormone. There are no satisfactory criteria for the diagnosis of neurosecretory growth-hormone dysfunction. The closer to puberty these children are treated, the less likely it is that there will be benefits in terms of increased final height. Recommendations as to a 'safety first' approach to growth-hormone treatment are given. A multicentre controlled trial is urgently needed to establish the benefits of treating children with neurosecretory growth hormone dysfunction. 12 AUTHOR Zachmann M TITLE Interrelations between growth hormone and sex hormones: physiology and therapeutic consequences. SOURCE Horm Res; VOL 38 Suppl 1, 1992, P1-8 (REF: 60) ABSTRACT Animal experiments, analysis of growth hormone (GH) secretion in the human, studies on the synergistic metabolic effects between GH and sex hormones using the stable isotope 15N, and long-term growth evaluation of patients with GH and gonadotrophin deficiency treated with testosterone and hGH show that biologically important interrelations exist between GH and sex hormones. They are operative not only at the pituitary and gonadal levels but also in peripheral tissues, where sex hormones modify the metabolic and growth-promoting effects of GH. GH is also important for an optimal androgenic effect of testosterone in development of secondary sexual characteristics. Knowledge of these interrelations is not only of physiological interest, but also of practical clinical value.