scholarly journals Baseline characteristics and response to GH replacement of hypopituitary patients previously irradiated for pituitary adenoma or craniopharyngioma: data from the Pfizer International Metabolic Database

2006 ◽  
Vol 155 (2) ◽  
pp. 253-260 ◽  
Author(s):  
D Maiter ◽  
R Abs ◽  
G Johannsson ◽  
M Scanlon ◽  
P J Jönsson ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Replacement Therapy ◽  
Fat Mass ◽  
Density Lipoprotein ◽  
Fat Free Mass ◽  
Beneficial Effects ◽  
Gh Replacement ◽  
Cholesterol Levels ◽  
Baseline Characteristics ◽  
Pituitary Irradiation

Objective: To test the hypothesis whether the effects of GH replacement therapy in adults could be affected by prior pituitary irradiation, the baseline characteristics and response to GH were evaluated in adults with severe GH deficiency (GHD), who had received or not irradiation for the treatment of pituitary adenoma or craniopharyngioma. Design: Data from 447 patients, who had received radiotherapy (427 in addition to surgery), and 630 patients, who were operated on but not irradiated for their tumour, were retrieved from Pfizer International Metabolic Database (KIMS) and compared at baseline and 1 and 2 years following the onset of GH replacement. Results: Irradiated and non-irradiated patients exhibited the expected phenotype of GHD at baseline. However, irradiated patients had a greater impairment in the quality of life (QoL), a higher fat mass, lower high-density lipoprotein cholesterol levels and a lower bone mineral content (BMC) than non-irradiated patients. Treatment with GH induced similar changes in both groups. After 1 year of GH replacement, there was an increase in serum IGF-I and fat-free mass, a reduction in fat mass and an improvement in QoL, all changes being equivalent in irradiated and non-irradiated patients. The lipid profile also improved with the irradiated patients showing a better response. These beneficial effects were maintained and the BMC also increased in both groups by the second year of treatment. Conclusions: This analysis shows that prior irradiation for pituitary adenoma or craniopharyngioma does not compromise the beneficial effects of GH replacement therapy.

scholarly journals Sheehan’s syndrome: baseline characteristics and effect of 2 years of growth hormone replacement therapy in 91 patients in KIMS – Pfizer International Metabolic Database

2005 ◽  
Vol 152 (4) ◽  
pp. 581-587 ◽  
Author(s):  
Fahrettin Keleştimur ◽  
Peter Jonsson ◽  
Senay Molvalilar ◽  
Jose Manuel Gomez ◽  
Christoph J Auernhammer ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Replacement Therapy ◽  
Hormone Replacement ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Hormone Deficiency ◽  
Sheehan’S Syndrome ◽  
Gh Replacement ◽  
Sheehan's Syndrome ◽  
Baseline Characteristics

Objective: Sheehan’s syndrome occurs as a result of ischaemic pituitary necrosis due to severe postpartum haemorrhage. It is one of the most important causes of hypopituitarism, and hence growth hormone deficiency (GHD), in developing countries. However, little is known about the effects of growth hormone (GH) replacement therapy in patients with Sheehan’s syndrome. Design: The demographic background characteristics of 91 GH-deficient patients with Sheehan’s syndrome (mean age ± s.d., 46.3 ± 9.4 years) were compared with those of a group of 156 GH-deficient women (mean age ± s.d., 51.5 ± 13.1 years) with a non-functional pituitary adenoma (NFPA). The baseline characteristics and the effects of 2 years of GH replacement therapy were also studied in the 91 patients with Sheehan’s syndrome and an age-matched group of 100 women with NFPA (mean age ± s.d. 44.5 ± 10.2 years). Results: All patients were enrolled in KIMS (Pfizer International Metabolic Database). Patients with Sheehan’s syndrome were significantly younger at pituitary disorder onset, diagnosis of GHD and at entry into KIMS than patients with NFPA (P < 0.01), and had significantly lower insulin-like growth factor I levels (P < 0.001). At baseline, quality of life (QoL) was significantly (P < 0.05) reduced in patients with Sheehan’s syndrome compared with those with NFPA (P < 0.001). With regard to treatment effects, lean body mass increased significantly (P < 0.05), QoL improved significantly (P < 0.05) and total and low-density lipoprotein-cholesterol decreased significantly (P < 0.05) in patients with Sheehan’s syndrome after 1 year of GH replacement therapy. Similar significant changes in QoL and lipid profiles occurred in patients with NFPA after 2 years of GH replacement. Blood pressure remained unchanged in patients with Sheehan’s syndrome, but decreased significantly (P < 0.01) in the group with NFPA after 1 year, before returning to pretreatment levels at 2 years. Conclusions: In conclusion, patients with Sheehan’s syndrome have more severe GHD compared with individuals with NFPA. GH replacement therapy in patients with Sheehan’s syndrome may have beneficial effects on QoL, body composition and lipid profile.

Baseline characteristics and effects of ten years of growth hormone (GH) replacement therapy in adults previously treated with pituitary irradiation

2013 ◽  
Vol 23 (6) ◽  
pp. 249-255 ◽  
Author(s):  
Mariam Elbornsson ◽  
Galina Götherström ◽  
Bengt-Åke Bengtsson ◽  
Gudmundur Johannsson ◽  
Johan Svensson
Keyword(s):  
Growth Hormone ◽  
Replacement Therapy ◽  
Gh Replacement ◽  
Previously Treated ◽  
Baseline Characteristics ◽  
Pituitary Irradiation

Issues in the Transition From Childhood to Adult Growth Hormone Therapy

PEDIATRICS ◽  
1999 ◽  
Vol 104 (Supplement_5) ◽  
pp. 1004-1010
Author(s):  
David B. Allen
Keyword(s):  
Growth Hormone ◽  
Replacement Therapy ◽  
Blood Lipid ◽  
Hormone Deficiency ◽  
Late Adolescent ◽  
Gh Therapy ◽  
Gh Treatment ◽  
Beneficial Effects ◽  
Gh Replacement ◽  
Adult Growth

The consequences of severe growth hormone deficiency (GHD) in adults and the beneficial effects of GH replacement therapy are clear. However, the majority of children who have a diagnosis of GHD and who are treated with GH do not have permanent GHD and will not require treatment during adulthood. Several issues must be considered in selecting candidates for adult GH treatment and transitioning their care from pediatrics to adult medicine. Counseling about possible lifelong treatment should focus on children with panhypopituitarism and those with severe isolated GHD that is associated with central nervous system abnormalities. When to terminate growth-promoting GH therapy should be guided by balancing the high cost of late-adolescent treatment with the attainment of reasonable statural goals. Retesting for GH secretion is appropriate for all candidates for adult GH therapy; the GH axis can be tested within weeks after the cessation of treatment, but confirming an emerging adult GHD state with body composition, blood lipid, and quality-of-life assessments may require 1 year or more of observation. Selecting patients for lifelong adult GH replacement therapy will present diagnostic, therapeutic, and ethical problems similar to those in treating childhood GHD. The experience and expertise of pediatric endocrinologists in diagnosing and treating GHD should be offered and used in identifying and transitioning appropriate patients to adult GH therapy.

Regrowth of non-secreting pituitary adenoma and craniopharyngioma prior to GH-replacement therapy in KIMS

1998 ◽  
Vol 8 (4) ◽  
pp. 318
Author(s):  
P Wilton ◽  
R Abs ◽  
B-A Bengtsson ◽  
U Feldt-Rasmussen ◽  
E Hernberg-Stahl ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Replacement Therapy ◽  
Gh Replacement

scholarly journals Baseline Characteristics and Effects of Growth Hormone Therapy over Two Years in Younger and Elderly Adults with Adult Onset GH Deficiency

2006 ◽  
Vol 91 (11) ◽  
pp. 4408-4414 ◽  
Author(s):  
Celina Franco ◽  
Gudmundur Johannsson ◽  
Bengt-Åke Bengtsson ◽  
Johan Svensson
Keyword(s):  
Elderly Patients ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
The Elderly ◽  
Adult Onset ◽  
Mineral Density ◽  
Open Label ◽  
Gh Replacement ◽  
Waist Hip Ratio ◽  
Baseline Characteristics

Abstract Context: The effects of GH replacement in elderly GH-deficient (GHD) adults are not well known. Objective/Design/Patients: In this prospective, single-center, open-label study, baseline characteristics and the effects of 2-yr GH replacement were determined in 24 GHD adults above 65 yr of age and in 24 younger GHD patients (mean age, 37 yr; range, 27–46 yr). All patients had adult onset disease, and both groups were comparable in terms of the number of pituitary hormonal deficiencies, gender, body mass index, and waist/hip ratio. Duration of hypopituitarism was, however, longer in the elderly patients. Results: The mean maintenance dose of GH was 0.31 (sem, 0.03) mg/d in the elderly GHD patients and 0.44 (0.04) mg/d in the younger patients. The less marked response in IGF-I sd score, total body fat, and extracellular water in the elderly patients lost significance when the dose of GH was accounted for in the statistical analyses. Despite the lower dose in the elderly GHD group, these patients had a more marked reduction in waist/hip ratio and serum low-density lipoprotein-cholesterol level, and these differences remained also after correction for duration of hypopituitarism. There was no difference at baseline or in responsiveness in lean mass, bone mineral density, and glucose homeostasis. Conclusions: This study identifies elderly GHD adults as a GH-sensitive group in whom a low dose of GH can improve body composition and serum lipid profile without any significant impairment of glucose metabolism. GH replacement should therefore be considered in elderly GHD adults.

scholarly journals Different metabolic responses induced by long-term interdisciplinary therapy in obese adolescents related to ACE I/D polymorphism

2017 ◽  
Vol 18 (2) ◽  
pp. 147032031770345 ◽  
Author(s):  
Sandro S Almeida ◽  
Flavia C Corgosinho ◽  
Carlos EN Amorim ◽  
Marcos F Gregnani ◽  
Raquel MS Campos ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Low Density Lipoprotein ◽  
Insulin Response ◽  
Density Lipoprotein ◽  
Fat Free Mass ◽  
Interdisciplinary Therapy ◽  
Obese Adolescents ◽  
Cholesterol Levels ◽  
The Metabolic Syndrome

Introduction: The main purpose of the present study was to investigate whether I/D polymorphism of the ACE gene might affect metabolic changes related to the metabolic syndrome through a long-term interdisciplinary therapy in obese adolescents. Methods: In total, 125 obese adolescents who entered the interdisciplinary obesity programme were assigned to the following two subgroups: metabolic syndrome or non-metabolic syndrome. They were evaluated at baseline and after 1 year. Genomic DNA was extracted from circulating leukocytes. Results: Subjects with the II genotype in the non-metabolic syndrome group were only to increase their fat-free mass after therapy. Regarding lipid profile, subjects with ID and DD genotypes from both groups reduced their low-density lipoprotein cholesterol levels significantly. The metabolic parameters from the ID and DD genotypes of the non-metabolic syndrome group showed a significantly improved insulin response. Conclusion: In the present study, we showed that the ACE polymorphism was able to influence the fat-free mass in the I-carry allele in the non-metabolic syndrome group positively. In addition, the I-carry allele was able to improve the insulin resistance of the metabolic syndrome group significantly. These results suggest that the ACE I/D genotypes can influence, in different ways, the specific parameters of metabolism among obese adolescents submitted for long-term interdisciplinary therapy.

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