ЭНДOКРИННЫЙ ДИСБAЛAНС: СOМAТOТРOПНAЯ НЕДOСТAТOЧНOСТЬ, ЭПИДЕМИOЛOГИЯ И КЛЮЧЕВЫЕ AСПЕКТЫ ДИAГНOСТИКИ У ДЕТЕЙ

Аннотация

Growth hormone (GH) deficiency is the most prevalent pituitary hormone deficiency and represents one of the leading causes of short stature in children and adolescents. The growth hormone–insulin-like growth factor 1 (GH–IGF-1) axis constitutes a central endocrine pathway regulating linear growth during childhood. Pituitary GH is encoded by the GH1 gene and is secreted into the bloodstream in a pulsatile manner. Its secretion is modulated by a complex interplay of hormonal signals, including stimulatory factors such as hypothalamic growth hormone-releasing hormone (GHRH), ghrelin, and sex steroids, as well as inhibitory agents such as somatostatin, IGF-1, and glucocorticoids. GH deficiency may manifest as either isolated growth hormone deficiency (IGHD) or as part of multiple pituitary hormone deficiencies (MPHD). The diagnosis is established based on clinical presentation, biochemical testing, and radiological findings. In the differential diagnosis of various forms of short stature, particularly in cases of syndromic short stature, karyotyping and chromosomal microarray analysis are employed to identify underlying genetic abnormalities. While somatotropic hormone deficiency is not curable, it can be effectively managed through hormone replacement therapy. When initiated promptly and administered appropriately, such therapy enables affected individuals to attain normal growth parameters and lead a full and healthy life. Background. The aim of this review is to examine the prevalence of growth hormone deficiency, its clinical manifestations, and the key aspects of its diagnosis and treatment. This condition holds not only medical but also social significance, as it necessitates a comprehensive approach to both prevention and management. Conclusion. Thus, growth hormone deficiency in children represents a significant medical and biological issue, characterized by impaired growth hormone secretion and, consequently, delayed physical development. Timely diagnosis and the initiation of replacement therapy with recombinant somatotropin can lead to normalization of growth and improved prognosis regarding both somatic health and psycho-emotional well-being. Key words: growth hormone deficiency, epidemiology, growth hormone, Insulin-like Growth Factor 1 (IGF-1), GH–IGF-1 Axis, stimulation test, recombinant growth hormone therapy.