儿童生长激素缺乏症

应定期监控 TFT，因为治疗可暴露甲状腺功能减退症。[66]Porretti S, Giavoli C, Ronchi C, et al. Recombinant human GH replacement therapy and thyroid function in a large group of adult GH-deficient patients: when does L-T(4) therapy become mandatory? J Clin Endocrinol Metab. 2002;87:2042-2045.http://www.ncbi.nlm.nih.gov/pubmed/11994338?tool=bestpractice.com

中枢性甲状腺功能减退症

持续未经治疗的 GHD 会导致终身高严重不足。未经治疗的 GHD 儿童患者达到的终身高标准差分值 (SDS) 为 -4 至 -6。[28]Wit JM, Kamp GA, Rikken B. Spontaneous growth and response to growth hormone treatment in children with growth hormone deficiency and idiopathic short stature. Pediatr Res. 1996;39:295-302.http://www.ncbi.nlm.nih.gov/pubmed/8825803?tool=bestpractice.com[29]Ranke MB, Price DA, Albertsson-Wikland K, et al. Factors determining pubertal growth and final height in growth hormone treatment of idiopathic growth hormone deficiency: analysis of 195 patients of the Kabi Pharmacia International Growth Study. Horm Res. 1997;48:62-71.http://www.ncbi.nlm.nih.gov/pubmed/9251922?tool=bestpractice.com

未经治疗的 GHD 与骨密度 (BMD) 下降相关，对童年发生 GHD 的青年患者持续进行 GH 治疗会与 BMD 的改善相关。[84]Conway GS, Szarras-Czapnik M, Racz K, et al. Treatment for 24 months with recombinant human GH has a beneficial effect on bone mineral density in young adults with childhood-onset GH deficiency. Eur J Endocrinol. 2009;160:899-907.http://www.ncbi.nlm.nih.gov/pubmed/19324976?tool=bestpractice.com

骨质疏松症

患有 GHD 的成人通常情绪低落、乏力、性欲减退和社交困难，[85]de Boer H, Blok GJ, Van der Veen EA. Clinical aspects of growth hormone deficiency in adults. Endocrinol Rev. 1995;16:63-86.http://www.ncbi.nlm.nih.gov/pubmed/7758433?tool=bestpractice.com[86]Rosen T, Wiren L, Wilhelmsen L, et al. Decreased psychological well-being in adult patients with growth hormone deficiency. Clin Endocrinol (Oxf). 1994;40:111-116.http://www.ncbi.nlm.nih.gov/pubmed/8306469?tool=bestpractice.com这些都会在 GH 治疗后改善。[87]Attanasio AF, Shavrikova EP, Blum WF, et al. Quality of life in childhood onset growth hormone-deficient patients in the transition phase from childhood to adulthood. J Clin Endocrinol Metab. 2005;90:4525-4529.http://press.endocrine.org/doi/full/10.1210/jc.2005-0439http://www.ncbi.nlm.nih.gov/pubmed/15899956?tool=bestpractice.com[88]Moock J, Albrecht C, Friedrich N, et al. Health-related quality of life and IGF-1 in GH-deficient adult patients on GH replacement therapy: analysis of the German KIMS data and the Study of Health in Pomerania. Eur J Endocrinol. 2009;160:17-24.http://www.ncbi.nlm.nih.gov/pubmed/18974232?tool=bestpractice.com

可能存在胰岛素不敏感性和 2 型糖尿病的风险。这可见于未经治疗的 GHD 成人患者，他们的胰岛素不敏感性可在其接受治疗期间恶化。[93]Møller N, Jørgensen JO. Effects of growth hormone on glucose, lipid, and protein metabolism in human subjects. Endocr Rev. 2009;30:152-177.http://www.ncbi.nlm.nih.gov/pubmed/19240267?tool=bestpractice.com

成人 2 型糖尿病

GHD 对心血管疾病发病和死亡的长期影响尚不明确。但是，GHD 成人患者的脂肪量会升高，去脂体重和骨重会降低，经常超重并且脂质升高。GH 治疗还与颈动脉内膜厚度降低和对胰岛素的不敏感相关。[89]Colao A, Di Somma C, Spiezia S, et al. Growth hormone treatment on atherosclerosis: results of a 5-year open, prospective, controlled study in male patients with severe growth hormone deficiency. J Clin Endocrinol Metab. 2008;93:3416-3424.http://press.endocrine.org/doi/full/10.1210/jc.2007-2810http://www.ncbi.nlm.nih.gov/pubmed/18593773?tool=bestpractice.com垂体功能减退症患者（尤其是女性）中，心血管死亡率会升高。[90]Rosen T, Bengtsson BA. Premature mortality due to cardiovascular disease in hypopituitarism. Lancet. 1990;336:285-288.http://www.ncbi.nlm.nih.gov/pubmed/1973979?tool=bestpractice.com[91]Bülow B, Hagmar L, Eskilsson J, et al. Hypopituitary females have a high incidence of cardiovascular morbidity and an increased prevalence of cardiovascular risk factors. J Clin Endocrinol Metab. 2000;85:574-584.http://press.endocrine.org/doi/full/10.1210/jcem.85.2.6346http://www.ncbi.nlm.nih.gov/pubmed/10690858?tool=bestpractice.com[92]Tomlinson JW, Holden N, Hills RK, et al. Association between premature mortality and hypopituitarism. West Midlands Prospective Hypopituitary Study Group. Lancet. 2001;357:425-431.http://www.ncbi.nlm.nih.gov/pubmed/11273062?tool=bestpractice.com GH 治疗可以逆转和减少许多异常情况。[77]Amato G, Carella C, Fazio S, et al. Body composition, bone metabolism, and heart structure and function in growth hormone (GH)-deficient adults before and after GH replacement therapy at low doses. J Clin Endocrinol Metab. 1993;77:1671-1676.http://www.ncbi.nlm.nih.gov/pubmed/8263158?tool=bestpractice.com[78]Carroll PV, Christ ER, Bengtsson BA, et al. Growth hormone deficiency in adulthood and the effects of growth hormone replacement: a review. Growth Hormone Research Society Scientific Committee. J Clin Endocrinol Metab. 1998;83:382-395.http://press.endocrine.org/doi/full/10.1210/jcem.83.2.4594http://www.ncbi.nlm.nih.gov/pubmed/9467546?tool=bestpractice.com但是，尚不明确治疗是否与死亡率下降相关。

急性冠脉综合征概述