Improvements in Body Composition after 4 Years of Growth Hormone Treatment in Adult-Onset Hypopituitarism Compared to Age-Matched Controls

Postma, MJ; Beek, André P van; Jönsson, Pernilla; Bunderen, Christa C. van; Drent, Madeleine L.; Mattsson, Anders; Camacho‐Hübner, Cecilia

doi:10.1159/000499430

Cited by 8 publications

(8 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It has to be taken into account that the existence of a gender speci city in the responsiveness to rhGH replacement with regard to body composition is still a matter of debate [11,13,38,39]; our results are in line with those of Franco et al [11] and Mukherjee et al [13], suggesting that males may experience greater changes in fat mass than females in response to GH. The reason for this difference still needs to be elucidated, but some evidences suggest that androgens may play a major role.…”

Section: Discussionsupporting

confidence: 90%

Bone and body composition analyses by DXA in adults with GH deficiency: effects of long-term replacement therapy

et al. 2021

View full text Add to dashboard Cite

Purpose: The effects of growth hormone (GH) replacement on bone mass and body composition in adult with GH de ciency (AGHD) are still debated with regard to their persistence in the long term. Moreover, the impact of gender on the response to GH is controversial. Aim of this study was to evaluate the long-term effects of rhGH replacement on bone mass and body composition in a monocentric cohort of patients with AGHD.Methods: Data from 138 patients with AGHD (34.3 ± 14.3 years, 48 women and 90 men) treated with rhGH for a period of at least 3 years up to a maximum of 10 were retrospectively collected. Bone mineral density (BMD) at the lumbar spine, femur, and radius, and total and truncular body composition were evaluated by dual energy X-ray absorption (DXA) before and during treatment. Clinical and laboratory evaluations were performed before and during the treatment period on an annual basis.Results: Lumbar spine BMD consistently increased in males, while in females decreased after a transient improvement observed during the rst 4 years of therapy. There were no signi cant changes in femoral BMD in either sexes, while a progressive increase at radius was observed only in males. Lean mass signi cantly increased in both sexes, while fat mass decreased only in males.Conclusions: In AGHD patients long-term rhGH replacement therapy induces a positive effect with regard to bone mass and body composition. A sexual dimorphism in the response to treatment is evident, with males displaying more favorable outcome.

show abstract

Section: Discussionsupporting

confidence: 90%

Bone and body composition analyses by DXA in adults with GH deficiency: effects of long-term replacement therapy

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Although true GH deficiency tends to modestly increase adipose tissue and decrease muscle mass, and these minor effects are reversible after GH replacement, obesity cannot be attributed to GH deficiency per se nor is GH deficiency a major contributor for obesity (167,168). For all of the above, neither basal IGF-I nor basal or stimulated GH should be measured when evaluating obese patients, nor should GH treatment be considered an option for the treatment of obesity.…”

Section: Reasoningmentioning

confidence: 99%

European Society of Endocrinology Clinical Practice Guideline: Endocrine work-up in obesity

Pasquali

Casanueva

Haluzı́k

et al. 2020

European Journal of Endocrinology

126

156

View full text Add to dashboard Cite

Obesity is an emerging condition, with a prevalence of ~20%. Although the simple measurement of BMI is likely a simplistic approach to obesity, BMI is easily calculated, and there are currently no data showing that more sophisticated methods are more useful to guide the endocrine work-up in obesity. An increased BMI leads to a number of hormonal changes. Additionally, concomitant hormonal diseases can be present in obesity and have to be properly diagnosed – which in turn might be more difficult due to alterations caused by body fatness itself. The present European Society of Endocrinology Clinical Guideline on the Endocrine Work-up in Obesity acknowledges the increased prevalence of many endocrine conditions in obesity. It is recommended to test all patients with obesity for thyroid function, given the high prevalence of hypothyroidism in obesity. For hypercortisolism, male hypogonadism and female gonadal dysfunction, hormonal testing is only recommended if case of clinical suspicion of an underlying endocrine disorder. The guideline underlines that weight loss in obesity should be emphasized as key to restoration of hormonal imbalances and that treatment and that the effect of treating endocrine disorders on weight loss is only modest.

show abstract

“…At baseline the patients were often overweight or obese, a finding reported in other groups of GHD patients (13). In general, weight and BMI are unchanged by GH replacement therapy (12), however when compared to age-matched healthy controls, GH treatment has shown beneficial effects over 4 years (14).…”

Section: Discussionmentioning

confidence: 74%

“…At baseline, 81 adults with LCH (27 with childhood onset, 56% females), mean age at GHD onset of 29 ( 15 ) years were studied. Diabetes insipidus was diagnosed in 86% of patients.…”

Section: Resultsmentioning

confidence: 99%

Pituitary function and the response to GH therapy in patients with Langerhans cell histiocytosis: analysis of the KIMS database

Touraine¹,

Sagna

Mattsson

et al. 2022

European Journal of Endocrinology

View full text Add to dashboard Cite

Objective: To analyze the effectiveness and safety of GH replacement treatment in adult patients with Langerhans Cell Histiocytosis (LCH) and GH deficiency (GHD) enrolled in KIMS (Pfizer International Metabolic Database). Patients and Methods: Patients with LCH and GHD were studied at baseline and for some of them after 1 year of GH treatment. Effectiveness of GH is presented as change after one-year of treatment (mean, 95% CI). The LCH population was compared to two other groups of patients enrolled in KIMS, granulomatous and lymphocytic hypophysitis. Results: At baseline, 81 adults with LCH (27 with childhood onset, 56% females), mean age at GHD onset 29 (15) years were studied. Diabetes insipidus was diagnosed in 86% of patients. Analysis of one-year of GH treatment was possible in 37 patients. One-year cross sectional values for the GH dose were 0.39 (SD±0.21) mg and -0.5 (-1.2 to 0.2) for IGF-I SDS. Total cholesterol decreased 0.9 (-1.5 to -0.3 (mmol/L); p<0.05); AGHDA-QoL-score (n=20) was improved by 2.8 points (-5.6 to 0.0; p<0.05), while mean BMI increased 0.6 ± 3 kg/m2 (95% CI: -0.2–1.4). All these effects did not differ from the two other groups after adjusting for age, gender, and baseline values. In 20 of 77 patients included in the safety analysis, 36 serious adverse events were reported during 435 patient-years (82.8/1000); no new safety signals were reported. Conclusion: After one year of GH treatment in patients with LCH, metabolic variables and quality of life improved, with no new safety signals.

show abstract

Improvements in Body Composition after 4 Years of Growth Hormone Treatment in Adult-Onset Hypopituitarism Compared to Age-Matched Controls

Cited by 8 publications

References 29 publications

Bone and body composition analyses by DXA in adults with GH deficiency: effects of long-term replacement therapy

Bone and body composition analyses by DXA in adults with GH deficiency: effects of long-term replacement therapy

European Society of Endocrinology Clinical Practice Guideline: Endocrine work-up in obesity

Pituitary function and the response to GH therapy in patients with Langerhans cell histiocytosis: analysis of the KIMS database

Contact Info

Product

Resources

About