Endocrine Abstracts (2008) 16 P386

Isolated GH deficiency of adult-onset in the KIMS database: prevalence, clinical presentation, and response to GH replacement

Felipe Casanueva1, Roger Abs2, Vera Popovic3, Maria Koltowska-Haggstrom4, Bjorn Jonsson5, Bernhard Saller6 & Ione Kourides7


1Endocrine Division, University of Santiago de Compostela, Santiago de Compostela, Spain; 2Department of Endocrinology, University of Antwerp, Edegem, Belgium; 3Neuroendocrine Unit, University Clinical Center, Belgrade, Serbia; 4KIMS Medical Outcomes, Pfizer Endocrine Care, Stockholm, Sweden; 5Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden; 6EBT Ophthalmology/Endocrine Care, Pfizer Global Pharmaceuticals, London, UK; 7WW Endocrine Care Team, Pfizer Inc., New York, USA.


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 60–65% 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.

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