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Determined by bioelectrical impedance analysis available to support the influence the results such as radiation, chemotherapy, immunosuppression, congenital diseases 4 Concomitant treatments are not always referred in the studies 5 In the long-term results we must consider the effect of age and hypopituitarism 6 In some studies follow-up is short to reach conclusive results on cardiovascular disease, neoplasia or mortality 7 Exposure to GH very variable in the patients included 8 Not all patients exposed to GH are captured in post-marketing studies 9 The studies are very heterogeneous and the designs are.