COGHD may be of genetic origin associated with deficiency of other pituitary hormones. Non treatment with GH in these cases can cause metabolic and other disturbances. The aim of this research was examining consequences of non treated COGDH in three sisters with familial hypopituitarism. Three sisters 60-, 59- and 54-year-old with familial hypopituitarism (GH,TSH, gonadotropin and prolactin deficiency) which was diagnosed 46 years before were examined. Substitution therapy performed only with thyroid hormones and gonadal steroids. We examined anterior pituitary hormones, body mass index BMI, body composition by BIA, lipids, OGTT with glycemia, insulin and C-peptide, bone metabolism and densitometry by DXA. Levels of pituitary hormones confirmed above mentioned deficiency and good substitution of thyroid deficiency. Therapy with gondal steroids was interrupted some years ago. Low level of IGF-I (<0.25 ng/ml) in all of them confirmed GHD. BMI and body composition were normal in all. High level of total cholesterol, LDL, triglycerides and low level of HDL were present in all of them. OGTT excluded disturbances of carbohydrate metabolism. Bone markers showed accelerated bone metabolism only in the oldest sister (osteocalcin 51.5 ng/ml, β-crosslaps 932 pg/ml). Two sisters had osteoporosis (T score: −2.76 in the oldest and the second oldest −4.2), and the youngest one had osteopenia with T score −2.4.
Conclusion: Non treated COGDH in familial hypopituitarism can cause disturbances in lipid and lipoprotein metabolism, bone mineral density and bone metabolism without disturbances of carbohydrate metabolism, obesity and pathological body composition.
03 - 07 May 2008
European Society of Endocrinology