Of the ~12 500 GH treated subjects with adult-onset GH deficiency (GHD) in KIMS (Pfizer International Metabolic Database), 3744 with multiple pituitary hormone deficiencies (MPHD) and 367 (9%) with isolated GHD (iGHD) were eligible for baseline analysis. Subjects met the following inclusion criteria: 1) never received GH prior to entry in KIMS, 2) had stimulation tests with insulin or glucagon (GH<3 μg/l), arginine (GH<0.4 μg/l), or arginine+GHRH (cut-offs based on BMI), 3) had organic disease as the cause of hypopituitarism. About 6065% of subjects in both groups had pituitary adenomas. At baseline iGHD subjects were younger than MPHD subjects (46.7 vs 48.7 years, P<0.01), had a shorter history of GHD (1.4 vs 2.1 years, P<0.001), a lower lean body mass (53.6 vs 56.3 kg, P<0.05) but similar BMI, a higher IGF-I SDS (−1.2 vs −1.7, P<0.001), and a worse QoL-AGHDA score (12.8 vs 11.6, P<0.05). Longitudinal analysis after 2-years of GH replacement compared to baseline showed a similar response in the iGHD (n=180) group compared to the MPHD (n=2140) group, the only difference being a more pronounced increase in IGF-I SDS (2.2 vs 1.7, P<0.001). Significant changes in the iGHD group were observed: waist (94.0 vs 95.2 cm, P<0.05; LDL cholesterol (3.4 vs 3.7 mmol/l, P<0.001); triglycerides (1.8 vs 2.0 mmol/l, P<0.02); QoL-AGHDA score (improving from 13.0 to 8.4, P<0.001); IGF-I SDS (0.5 vs −1.2, P<0.001).
In conclusion: iGHD patients should receive GH replacement since they respond as well as MPHD patients.
03 - 07 May 2008
European Society of Endocrinology