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Blood 128:318319 Goldschmidt H, Mai E, Nievergall E, Fenk R, Bertsch U, Tichy D et al (2021) Addition of isatuximab to lenalidomide, bortezomib and dexamethasone as induction therapy for newly-diagnosed, transplant-eligible multiple myeloma patients: the phase III GMMG-HD7 trial

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The risk of deficiency increases if a woman follows a restricted diet

Malnutrition or malabsorption causes decreased insulin signaling which reduces GHR expression and blocks the GH signaling pathway leading to IGF-I expression (GHR uncoupling), while GHs metabolic actions on lipolysis and gluconeogenesis are unaffected