MEDizzy - A 58-year-old man undergoes severe head trauma and develops

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A 58-year-old man undergoes severe head trauma and develops pituitary insufciency. After recovery, he is placed on thyroid hormone, testosterone, glucocorticoids, and vasopressin. On a routine visit, he questions his primary care physician regarding potential growth hormone defciency. All of the following are potential signs or symptoms of growth hormone defciency EXCEPT:

ExplanationAdult growth hormone defciency is usually caused by hypothalamic or pituitary damage. Because growth hormone is no longer important for achieving stature, the presentation is diferent from childhood growth hormone defciency. Although growth hormone has direct tissue efects, it primarily acts through increasing secretion of IGF-1, which in turn stimulates lipolysis, increases circulating fatty acids, reduces omental fat mass, and enhances lean body mass. Thus, defciency of growth hormone causes the opposite efects. In addition, hypertension, left ventricular dysfunction, and increased plasma fbrinogen levels may also be present with defcient growth hormone. Reduced, not increased, bone mineral density may also occur in adults with growth hormone defciency.