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DOI: 10.1146/annurev.med.52.1.108 GH Deficiency and Replacement Research Extensive pre-clinical and clinical research using recombinant hGH has characterised the effects of GH deficiency across the lifespan — from childhood growth failure to adult-onset GH deficiency with associated body composition, metabolic, and quality-of-life effects — establishing the pharmacological profile of HGH 191AA replacement in deficiency models that forms the pre-clinical basis for current GH replacement research