La sicurezza dell'impiego del GH nell'età evolutiva.

The increasing spectrum of indications of growth hormone (GH) therapy requires an appropriate knowledge of its adverse events and shortllong-term safety. Aim of this chapter was the revision of the data about the safety of GH-therapy during paediatric age. Regarding short-term security, we discussed the effects of GH on glucose tolerance and risk of type2 diabetes mellitus and other known adverse events as benign intracranial hypertension and orthopedic complications. Separate sections are dedicated to all-cause mortality and the risk of sudden death in children with Prader-Willi syndrome and to the association between GH therapy and the risk of cancers diseases. Data regarding long-term adverse events are lacking; we discussed the role of monitoring IGF-I/IGFBP-3 during GH therapy and the risk of glucose intolerance and metabolic syndrome at the end of treatment. Finally, we reviewed the preliminary results and limitations of the "SAGhE" study, the larger European study on long therm safety so far conducted.