Abstract

OBJECTIVE
Effects of GH replacement in patients with GH deficiency (GHD) after a cure for acromegaly so far have been poorly studied, although its prevalence among acromegalic patients may reach the 60%. The aim of the study was to evaluate whether metabolic parameters and quality of life are improved by GH replacement in patients with prior acromegaly and severe GHD.
DESIGN AND METHODS
This was a prospective study on 42 GHD subjects [22 men, mean age (sd): 48 ± 10]: 10 acromegalics treated with recombinant human GH (group A), 12 acromegalics who refused treatment (group B), and 20 subjects operated for nonfunctioning pituitary adenoma on recombinant human GH (group C). Serum IGF-I levels, lipid profile, glucose levels (fasting and after an oral glucose tolerance test), glycosylated hemoglobin, insulin resistance (homeostasis model assessment insulin resistance index), anthropometric parameters (body mass index, waist circumference, body composition), and quality of life (Questions on Life Satisfaction-Hypopituitarism Z-scores) were evaluated at baseline and after 12 and 36 months.
RESULTS
At baseline, group B showed higher IGF sd score than group A and C, as well as better quality of life and higher post-oral glucose tolerance test glucose levels than group A. After 12-months, similarly in group A and C, the IGF-I sd score significantly increased, and body composition and lipid profile improved, without deterioration of glucose tolerance. Quality of life significantly improved too, and the baseline difference between group A and B disappeared. Results were confirmed after 36 months.
CONCLUSIONS
In GHD acromegalic patients, GH therapy improved body composition, lipid profile, and quality of life as in patients with GHD due to nonfunctioning pituitary adenoma, without negative effects on glucose metabolism. GH replacement therapy should be considered in these patients, as in patients with GHD from other causes.

Links

Publisher Full Text

Authors

Giavoli C, Profka E, Verrua E, Ronchi CL, Ferrante E, Bergamaschi S, Sala E, Malchiodi E, Lania AG, Arosio M, Ambrosi B, Spada A, Beck-Peccoz P

Institution

Fondazione Instituto di Ricovero e Cura a Carattere Scientifico Cà Granda Ospedale Maggiore Policlinico, Endocrinology and Diabetology Unit, Via F. Sforza 35, 20122 Milan, Italy. claudiagiavoli@yahoo.it

Source

The Journal of clinical endocrinology and metabolism 97:11 2012 Nov pg 3983-8

MeSH

Acromegaly
Adult
Blood Glucose
Female
Hormone Replacement Therapy
Human Growth Hormone
Humans
Insulin-Like Growth Factor I
Lipids
Male
Middle Aged
Prospective Studies
Quality of Life
Recombinant Proteins
Treatment Outcome

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22904173