V Gasco1, L Roncoroni2, M Zavattaro2, C Bona2, A Berton2, E Ghigo2, M Maccario2, S Grottoli2. 1. Division of Endocrinology, Diabetes and Metabolism, Department of Medical Science, University of Turin, Turin, Italy. valentina.gasco@unito.it. 2. Division of Endocrinology, Diabetes and Metabolism, Department of Medical Science, University of Turin, Turin, Italy.
Abstract
PURPOSE: Uncertainties exist about the predictors of the severity of the clinical picture of GH deficiency (GHD) syndrome. Aim of the study was to evaluate, in adult patients with GHD, the predictors of the development of hypercholesterolemia, hypertension, diabetes mellitus, and osteoporosis. METHODS: We retrospectively studied 327 adult patients (age 47.1 ± 17.1 years) with untreated severe GHD (mean follow-up 110.9 ± 56.8 months). GHD was defined by GHRH + arginine test using BMI cut-offs. The possible development of hypercholesterolemia, hypertension, diabetes mellitus, and osteoporosis was investigated by Kaplan-Meier survival analysis. For each clinical outcome, either a univariate or multivariate analysis according to the Cox proportional-hazards model was performed to identify those factors that were associated with the development of the event. RESULTS: GH secretion parameters were not associated with the outcomes. Hypercholesterolemia was positively and negatively predicted by a BMI ≥ 30 kg/m2 (HR 2.50, p 0.00) and the dose of l-thyroxine possibly in place (HR 0.98, p 0.02), respectively. Hypertension was positively predicted by a BMI ≥ 30 kg/m2 (HR 2.64, p 0.00) and IGF-I SDS values (HR 2.26, p 0.00). Diabetes mellitus was positively predicted by hypertension (HR 11.76, p 0.01). Osteoporosis was positively and negatively predicted by hypercholesterolemia (HR 3.25, p 0.01) and hypertension (HR 0.21, p 0.00), respectively. CONCLUSIONS: The severity of the impairment of GH secretion does not predict the development of the clinical picture of GHD syndrome: untreated adult GHD does not increase the development of metabolic risk factors in hypopituitaric patients.
PURPOSE: Uncertainties exist about the predictors of the severity of the clinical picture of GH deficiency (GHD) syndrome. Aim of the study was to evaluate, in adult patients with GHD, the predictors of the development of hypercholesterolemia, hypertension, diabetes mellitus, and osteoporosis. METHODS: We retrospectively studied 327 adult patients (age 47.1 ± 17.1 years) with untreated severe GHD (mean follow-up 110.9 ± 56.8 months). GHD was defined by GHRH + arginine test using BMI cut-offs. The possible development of hypercholesterolemia, hypertension, diabetes mellitus, and osteoporosis was investigated by Kaplan-Meier survival analysis. For each clinical outcome, either a univariate or multivariate analysis according to the Cox proportional-hazards model was performed to identify those factors that were associated with the development of the event. RESULTS: GH secretion parameters were not associated with the outcomes. Hypercholesterolemia was positively and negatively predicted by a BMI ≥ 30 kg/m2 (HR 2.50, p 0.00) and the dose of l-thyroxine possibly in place (HR 0.98, p 0.02), respectively. Hypertension was positively predicted by a BMI ≥ 30 kg/m2 (HR 2.64, p 0.00) and IGF-ISDS values (HR 2.26, p 0.00). Diabetes mellitus was positively predicted by hypertension (HR 11.76, p 0.01). Osteoporosis was positively and negatively predicted by hypercholesterolemia (HR 3.25, p 0.01) and hypertension (HR 0.21, p 0.00), respectively. CONCLUSIONS: The severity of the impairment of GH secretion does not predict the development of the clinical picture of GHD syndrome: untreated adult GHD does not increase the development of metabolic risk factors in hypopituitaricpatients.
Authors: G Aimaretti; M Boschetti; G Corneli; V Gasco; D Valle; M Borsotti; A Rossi; A Barreca; L Fazzuoli; D Ferone; E Ghigo; F Minuto Journal: J Endocrinol Invest Date: 2008-05 Impact factor: 4.256
Authors: G Muscogiuri; G P Sorice; R Ajjan; T Mezza; S Pilz; A Prioletta; R Scragg; S L Volpe; M D Witham; A Giaccari Journal: Nutr Metab Cardiovasc Dis Date: 2012-01-21 Impact factor: 4.222
Authors: Johan Verhelst; Anders F Mattsson; Anton Luger; Maria Thunander; Miklós I Góth; Maria Koltowska-Häggström; Roger Abs Journal: Eur J Endocrinol Date: 2011-10-03 Impact factor: 6.664
Authors: A Colao; G Cerbone; R Pivonello; G Aimaretti; S Loche; C Di Somma; A Faggiano; G Corneli; E Ghigo; G Lombardi Journal: J Clin Endocrinol Metab Date: 1999-04 Impact factor: 5.958
Authors: A Giustina; A Barkan; P Chanson; A Grossman; A Hoffman; E Ghigo; F Casanueva; A Colao; S Lamberts; M Sheppard; S Melmed Journal: J Endocrinol Invest Date: 2008-09 Impact factor: 4.256
Authors: G Amato; C Carella; S Fazio; G La Montagna; A Cittadini; D Sabatini; C Marciano-Mone; L Saccá; A Bellastella Journal: J Clin Endocrinol Metab Date: 1993-12 Impact factor: 5.958
Authors: Elena Gangitano; Giuseppe Barbaro; Martina Susi; Rebecca Rossetti; Maria Elena Spoltore; Davide Masi; Rossella Tozzi; Stefania Mariani; Lucio Gnessi; Carla Lubrano Journal: Cells Date: 2022-08-04 Impact factor: 7.666