Endocrine Abstracts

Aside its growth promoting effects, growth hormone (GH) displays other actions upon carbohydrate, lipid and protein metabolisms, and possibly also direct central nervous system effects. Fourteen adult pituitary dwarves (mean height of 132.3±8 cm, mean age of 30.7±9.6 y), 5 women and 9 men, never having received rGH therapy, were investigated. Body composition (BC) was assessed by bioelectrical impedance, and bone mineral density (BMD) was evaluated by quantitative ultrasound. Patients were submitted to psychological tests and examined by a psychologist and psychiatrist.

BC of GH-deficient adult dwarves was significantly modified: a reduced percentage of water (45.7±13.6% compared to 69.4±15% water in a BMI- and age-matched group with normal adult height) and an increased fat percentage (48.3±12.9% compared to 25.2±9.4% in normal-sized BMI-matched healthy controls, P<0.05). BMD was decreased in the group of pituitary dwarves, with a mean T score of −1.45±0.8 (in the range of osteopenia). When psychologically assessed, certain pituitary dwarves scored poorly at family and society adaptation (10 and 12 patients, respectively), whereas all but one patient had mild to profound self-esteem disturbances. Ten patients were resistant to refractory at any external help. Two dwarves had a high Beck depression score, three had suicidal thoughts and one had a suicidal attempt in her history. A strong correlation between the patients’ IQ and their quality of life estimated with the Guilford-Zimmerman score was observed (R²=0.764). Non-treated, childhood-onset GH deficiency leads therefore not only to dwarfism, but also to alterations in body composition and energy output. Modifications in their body image may have significant impact upon the adaptation of pituitary dwarves in the society, and on their quality of life. Their adaptation is dependent to a great extent of their mental capacity as well as of the degree of tolerance from the family and society.