Endocrine Abstracts

Several reports indicate that hypopituitarism is associated with decreased life expectancy compared to age-matched healthy controls and that this mortality penalty exists despite ‘adequate’ or ‘satisfactory’ replacement with glucocorticoids, thyroid hormone and sex steroids. Almost coincident with these studies came a series of randomised, placebo-controlled trials, in which it was convincingly demonstrated that treatment of growth hormone deficient (GHD) adults with recombinant human GH led to significant improvements in body, composition, well-being and serum lipoprotein levels. This has led to speculation that that the increased visceral adiposity and abnormal cardiovascular risk profile associated with adult GHD may contribute to the demonstrable decreased life expectancy and, by inference that treatment with rhGH may improve mortality outcome in adult hypopituitarism. This presentation will seek to explore and address the following questions:

Is hypopituitarism per se associated with increased mortality, or are there specific aetiologies (e.g. craniopharyngioma) hypopituitarism or treatments (e.g. radiotherapy) that contribute, at least in part?

Does non-physiological glucocorticoid replacement contribute to excess cardiovascular risk in patients with secondary hypoadrenalism?

Does insufficient thyroxine replacement for patients with hypopituitarism contribute to the abnormal cardiovascular risk profile?

What effect does GH therapy have on mortality?