Endocrine Abstracts

Objective: To evaluate cost-effectiveness of GH treatment (Genotropin) in adult patients with GHD by comparing health status and costs in patients who received GH treatment with those who did not.Methods: Direct costs included health care costs related to morbidity (stroke, cardiovascular events) and GH costs. Indirect costs were determined by sick-leave and mortality. A model (Markov-type) was constructed to simulate differences in morbidity and mortali...

Background: Hypopituitary patients with untreated growth hormone deficiency (GHD) have increased fat mass, dyslipidaemia and insulin resistance. Inappropriately low thyroxine doses in patients with central hypothyroidism (CH) may also promote such clinical features.Objective: To examine metabolic outcome of thyroxine replacement in hypopituitary patients before and after GH replacement.Method: One thousand and six hundred and two p...

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 ba...

A GH peak of 3 μg/l during the insulin tolerance test (ITT) is considered the gold standard for identifying adults with severe GH deficiency. Alternative stimuli such as arginine (AST) and glucagon (GST) are also employed but produce lower GH peaks than the ITT in normal subjects. Despite this, 3 μg/l is used as the diagnostic threshold for these tests, raising the possibility that severe GH deficiency is being diagnosed inappropriately.We stud...