Endocrine Abstracts

Patients with hypopituitarism and untreated growth hormone (GH) deficiency have excess mortality. GH replacement therapy (GHRT) has many beneficial effects, but its impact on mortality has not been proven and there are still safety concerns regarding the potential cancer risk. We have therefore studied the mortality in non-functioning pituitary adenoma (NFPA) patients with and without GHRT. Only patients with NFPA were studied in order to eliminate the influence of the aetiology of hypopituitarism.

NFPA patients within the Sahlgrenska University Hospital’s catchment-area (1.5 million inhabitants) were identified through the Swedish National Patient Registry. The records of all identified patients were reviewed. All patients were cross-referenced with the Swedish National Death Registry. The study period was 1987–2011. Standardised mortality ratios (SMRs) with 95% CIs (reference: Swedish population) were calculated.

We identified 435 patients with NFPA, out of which 433 had complete records and were included in the study. GHRT had been used for at least one year by 187 patients and 246 patients had not been treated with GHRT. Mean (±S.D.) age at diagnosis was lower (P<0.001) in the GHRT-group (54.3±11.7) than in the non-GHRT-group (64.0±15.4). Mean duration of GHRT was 10.9 (6.1) years and mean follow-up time in the non-GHRT-group was 6.9 (5.4) years. The total number of deaths in the study was 83. The overall SMR was 0.49 (0.27–0.80, P=0.003) for the GHRT-group and 0.98 (0.76–1.24; P=0.94) for the non-GHRT-group. The SMR was significantly lower in the GHRT-group compared to the non-GHRT-group (P=0.02). SMR for malignant neoplasms was significantly reduced in the GHRT-group (0.19; 0.02–0.68; P=0.003), and was not significantly changed in the non-GHRT-group (0.74; 0.37–1.31; P=0.37).

This is the first study to report a reduced mortality in NFPA patients receiving long-term GHRT. Furthermore, mortality due to malignant neoplasms was decreased in the GHRT-group and not in the non-GHRT-group.

Disclosure: This study received financial support from the Swedish government under the ALF-agreement.