Endocrine Abstracts

Background: Adults with growth hormone deficiency (GHD) have increased central fat deposits, hypertriglyceridemia, and hyperglycaemia, with an increased risk of developing metabolic syndrome and cardiovascular disease, conditions that can lead to a diminished quality of life. This study analyzed comorbidities among adults with GHD in the US who had Medicaid or commercial health insurance.

Methods: In this retrospective cohort study using IBM Marketscan Medicaid and Commercial Research Database data, adults (aged ≥18 years) diagnosed with GHD between Jan. 1, 2008, and Dec. 31, 2017, were matched (1:3) to controls without GHD (or other short stature-related disorders) on age, gender, plan type (commercial vs Medicaid), region, and race (Medicaid only). Baseline comorbidities and medications were measured during the 12 months pre-index. All-cause and GHD-related healthcare utilization and somatropin use were measured during the variable follow-up period.

Results: A total of 24.373 commercial and 2.579 Medicaid patients with GHD met the study inclusion criteria and were matched to 73.119 commercial and 7.728 Medicaid controls, respectively. Demographic makeup of patients with and without GHD was similar, demonstrating effective matching. About half the patients were male. Median age at index was 48 years for commercial patients and 37 years for Medicaid patients. Mean follow-up time was 35 and 37 months for commercial patients and controls, and 41 and 31 months for Medicaid patients and controls, respectively. GHD patients were disproportionately affected by comorbidities compared to controls: endocrine conditions (>68% in GHD cases vs. ≤10% in controls), metabolic conditions (>93% in GHD cases vs. ≤39% in controls), hepatic and renal function conditions (18-23% in GHD cases vs. <10% in controls), and cardiovascular disease (41-53% in GHD cases vs. <29% in controls), and were disproportionately treated with concomitant medications.

Conclusions: Adults with GHD experience a substantial comorbidity burden compared to non-GHD controls.