Endocrine Abstracts

Introduction: Growth hormone deficiency (GHD) is a medical condition affecting adults and children who lack sufficient growth hormone. The objective of this study was to compare diagnoses in acquired and idiopathic adult-onset GHD patients.

Methodology: Results are from Ipsos’ EU5 GHD Therapy Monitor Study 2018, which is an online study conducted among physicians treating both paediatric and adult GHD patients. 156 sampled physicians provided data on the last 5 consecutive GHD patients (reporting on 779 patients) seen between November 2018 and January 2019. Data included demographics, comorbidities, diagnostic tests, disease history, and treatment patterns. Descriptive analysis was conducted using appropriate statistical tests.

Results: Two thirds (66%) of adult-onset GHD patients (n = 220) treated by endocrinologists in the study have acquired GHD, whilst the remaining have idiopathic GHD. Specific tests used to confirm diagnosis in the two types of patient groups varies slightly. Adult-onset patients with acquired GHD are significantly more likely to have their diagnosis confirmed using an IGF-1 blood test than those with idiopathic GHD (89% vs 70%, P < 0.01). Idiopathic patients are significantly more likely than acquired patients to have had a hand X-ray (27% vs 6%, P < 0.01) and/or karyotyping (26% vs 3%, P < 0.01) tests to confirm diagnoses of GHD. Unsurprisingly, when looking at types of tests idiopathic GHD patients are significantly more likely to have genetic testing than those with acquired GHD to confirm diagnosis, likely due to the nature of the condition. While fatigue is the most common first symptom observed among the adult-onset GHD patients, data suggest it is more likely to impact acquired GHD patients than idiopathic patients (79% vs 47%, P < 0.01). Significantly more adult-onset patients with idiopathic GHD present with truncal obesity (45% vs 27%, P < 0.01) and dry skin (38% vs 21%, P < 0.01) than patients with acquire GHD.

Conclusion: There is a lack of standard diagnostic criteria for both acquired and idiopathic GHD leading to potential delays in diagnoses for the patient population. This study highlights the differences in first symptoms and diagnostic tests between idiopathic and acquired adult-onset GHD patients. Further research is needed to understand which diagnostic tests are being used in each type of GHD in order to identify a more standardised approach to diagnosis.