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Transition is the time encompassing the achievement of full height and complete somatic development, representing a period of physical, psychological, and social changes. Considering the beginning of social adaptation, the research of independence, and the desire to manage health conditions, the acceptance of chronic care should be poor. Patients affected by growth hormone deficiency (GHD), characterized by heterogeneity in diagnosis, high comorbidity burden, need for daily injections, and lack of biological markers during follow-up, could have a high drop-out rate. Replacement treatment is meaningful because, even if GHD is not life-threatening, it could represent a risk for long-term metabolic, cardiovascular, bone, and psychosocial complications with, eventually, a reduction in quality of life. Moreover, the diagnosis is not always straightforward, since the studies on stimulation tests are limited, or molecules are lacking, cutoffs are often not validated in transition patients, and follow-up requires attention in specific cases (i.e., cancer survivors). The present review aims to describe the features of GHD during transition, focusing on etiologies, pitfalls in diagnosis, GH replacement therapy, and follow-up issues., (© 2024 S. Karger AG, Basel.)

Purpose: The discrepancy between the biomarkers of disease's activity in acromegalic patients (GH and IGF-1) is almost frequent representing a challenge for the development of comorbidities in the long term. The aim of this study was to evaluate the prevalence and severity of metabolic comorbidities (diabetes, hypertension, and dyslipidemia) in surgically treated acromegalic patients with disease control and discordant GH and/or IGF-1 levels compared with those with concordant values., Patients and Methods: Retrospective monocentric observational study on acromegalic surgically treated patients with biochemical remission (group A) or mild discordant GH or IGF-1 levels (group B). Metabolic complications and medical therapy were assessed at diagnosis and at the last follow-up visit. Severity of the disease was set for drug titration or shift to another molecule or more than before., Results: There were 18 patients that met the inclusion criteria [group A: nine patients; group B: nine patients, follow-up 7 years (IQR 5.0;11.25)]. The prevalence of female patients was significantly higher in the remission group compared with the discordant group (p < 0.02). Considering metabolic complications, at the last follow-up, 61.1% was affected by hypertension, 33.3% by diabetes, and 61.1% by dyslipidemia, without differences between groups. Drug characteristics (dose, shift, number) during the follow-up did not differ significantly between groups., Conclusion: Metabolic complications, mainly dyslipidemia, are frequent in cured acromegalic patients, but GH/IGF-1 discrepancy does not seem to represent a risk factor for their presence or persistence. More extended studies are needed to confirm our results in a long-term period., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2023 Romanisio, Pitino, Ferrero, Pizzolitto, Costelli, Antoniotti, Marzullo, Aimaretti, Prodam and Caputo.)