Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2011) 26 P202

ECE2011 Poster Presentations Pituitary (111 abstracts)

Baseline characteristics and effects of 10 years of GH replacement therapy in adults previously treated with pituitary irradiation therapy

M Elbornsson , G Götherström , B-Æ Bengtsson , G Johannsson & J Svensson


Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden.


Context: Little is known of the importance of previous irradiation therapy for baseline characteristics and responsiveness to GH replacement in GH deficient (GHD) adults.

Objective/design/patients: In this prospective, single-centre, open-label study, the effects of 10-year GH replacement on metabolic variables and safety were determined in 18 GHD adults that had previously received pituitary irradiation therapy and 18 non-irradiated GHD patients. All patients had adult onset disease and complete deficiency of anterior pituitary hormones. Both groups were comparable in terms of gender, body mass index (BMI), and waist:hip ratio.

Results: At baseline, the GHD patients previously treated with pituitary irradiation therapy had higher serum levels of triglycerides (TG) and insulin and lower serum HDL-cholesterol level than non-irradiated patients (all P<0.05). The 10-year GH replacement improved serum lipid profile in both study groups, and in both groups variables reflecting glucose homeostasis responded similarly to GH replacement. At study end, serum HDL-cholesterol level was still lower in the GHD patients that had previously received pituitary irradiation therapy whereas serum TG and insulin levels were similar in both groups. During the 10-year GH replacement, four patients previously treated with pituitary irradiation therapy had cardiac events (two fatal) and one had a non-fatal cerebral infarction whereas only one non-fatal vascular event occurred in the non-irradiated patients.

Conclusions: GHD patients that have previously received pituitary irradiation therapy display a more severely impaired metabolic profile at baseline compared with non-irradiated patients. GH replacement can partly, but not fully, reverse these metabolic aberrations. This may be of importance for the more marked cardiovascular morbidity observed in this group.

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