Endocrine Abstracts

The contribution to adult growth hormone deficiency (GHD) of hormone replacement and other aspects of hypopituitarism are poorly defined. We compared baseline characteristics and response to GH treatment of patients with isolated GHD (IGHD, 16 patients) to patients with multiple pituitary hormone deficiencies (MPD, 135 patients). At baseline, MPD patients showed significantly greater waist-hip ratios (0.87 plus/minus 0.007 vs. 0.82 plus/minus 0.02, mean plus/minus SD; P < 0.05) and significantly lower LDL cholesterol (3.48 plus/minus 0.10 vs. 4.14 plus/minus 0.39; P < 0.05) than IGHD patients; QoL -AGHDA scores did not differ. After one year of GH treatment, serum IGF-I concentrations were in the normal range (IGHD: 271 plus/minus 101.6; MPD: 247 plus/minus 94.7 nanograms per ml). Waist-hip ratios were significantly reduced in MPD patients (0.87 plus/minus 0.009 vs. 0.85 plus/minus 0.008; P < 0.001) but remained higher than IGHD patients (0.85 plus/minus 0.008 vs. 0.80 plus/minus 0.02; P < 0.05). Both groups demonstrated a decrease in waist circumference (MPD reduction: -2.2cm plus/minus 6.4, P < 0.05, IGHD reduction: -2.83cm plus/minus 4.8, P = 0.07), cholesterol (baseline, 5.79 plus/minus 0.11; year 1, 5.35 plus/minus 0.14; P < 0.05) and LDL cholesterol (baseline, 3.58 plus/minus 0.10; year 1, 3.35 plus/minus 0.13; P < 0.05). MPD patients had a reduction in triglycerides (1.87 plus/minus 0.16 vs. 1.54 plus/minus 0.08; P < 0.05). QoL-AGHDA scores improved similarly in both groups (IGHD -7.6 plus/minus 3 vs. MPD -7.9 plus/minus 3.6; P < 0.05). We conclude that there are significant baseline differences between groups which persist after one year of GH replacement. However, IGHD and MPD show qualitatively similar responses to GH replacement in terms of improvement in body composition, lipoprotein profiles and quality of life score.